EPIDEMIOLOGICAL PROFILE OF FUNGAL KERATITIS IN PATIENTS ATTENDING A TERTIARY CARE CENTRE IN BIHAR

Introduction: Corneal blindness is a major public health problem worldwide and fungal keratitis is one of its predominant causes. The etiological and epidemiological pattern of fungal keratitis varies signicantly with patient population, geographical region and prevailing socioeconomic conditions. Objectives:The objective of the study was to identify the specic pathogenic agents and to study epidemiological characteristics of fungal keratitis presenting at a tertiary care centre in Patna, Bihar. Materials And Methods: Corneal scrapings were obtained from clinically suspected patients of keratomycosis during the period of 18 months from May 2015 to October 2016. The scraping material was processed and identied by standard laboratory techniques. Demographic and clinical features of the patients were also collected. Results: Out of total 115 suspected fungal corneal ulcers, 63(54.78%) were positive for fungal etiology. Of these, 53(84.13%) were positive on KOH mount. 40(63.49%) and 35(55.56%) were positive in Gram stain and culture respectively. In culture, aspergillus spp (16;45.71%) were the predominant fungal species, followed by fusarium spp (12;34.29%). Males (35/63;55.56%) were more commonly affected. 22 out of 63 patients (34.92%) were of age group 31-45 years. Majority of patients were farmers (68.25%). Corneal trauma (50.79%) was the most common predisposing factor in which trauma due to vegetative matter (53.13%) was most signicant. Conclusion: Fungal keratitis continues to be a cause of concern to ophthalmologists. Agricultural activity and related ocular trauma are principal causes of mycotic keratitis. A potassium hydroxide (KOH) wet mount preparation is a simple, and sensitive, method for diagnosis.

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Study of prevalence of maternal anaemia and its fetal outcome at rural tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184131 ◽

2018 ◽

Vol 7 (10) ◽

pp. 4077

Author(s):

Vandana Verma ◽

Soniya Vishwakarma ◽

Ramesh Chand ◽

Umesh Kumar Gupta

Keyword(s):

Public Health ◽

Developing Countries ◽

Health Problem ◽

Tertiary Care ◽

Public Health Problem ◽

Major Public Health Problem ◽

Care Centre ◽

Tertiary Care Centre ◽

Medical Disorders ◽

In Pregnancy

Background: Anaemia is a major public health problem especially among low socioeconomic class of the population in developing countries. Prevalence of anaemia among pregnant women in developing countries is 51%. Anaemia is defined by the WHO as haemoglobin levels of less than 11 gm. % in pregnancy. The present study was aimed to find out prevalence of anaemia in rural tertiary care centre to see the foetal outcome in anaemic women.Methods: This is a retrospective observational study done in the Department of Obstetrics and Gynaecology, University of medical sciences Saifai, Etawah from June 2017 to November 2017. All the women admitted to labour room in third trimester and delivered here were included in the study excluding the patients with pre-eclampsia, eclampsia, gestational diabetes mellitus, heart disease, patients with other medical disorders and patients with twin pregnancy, antepartum haemorrhage and the patients who did not deliver here.Results: Prevalence of anaemia was 87.3 %. severe anaemia was found in 3.5 % women. The percentage of preterm births was more in anaemic women that is 16.9 %.Conclusions: Anaemia in pregnancy is a major public health problem in India. The number of IUGR and LBW babies were more in anaemic women. Anaemia is related to serious consequences in mother and baby if not diagnosed and treated timely. It can be prevented by increasing the awareness regarding need of iron intake during pregnancy.

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Trends of leptospirosis cases in a tertiary care center in Northern Kerala during January 2013 to October 2019

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203897 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3397

Author(s):

Rameela Sanya ◽

Jayasree Anandabhavan Kumaran

Keyword(s):

At Risk ◽

Rainy Season ◽

Care Center ◽

Tertiary Care ◽

Public Health Problem ◽

Major Public Health Problem ◽

Older Individuals ◽

Care Centre ◽

Tertiary Care Centre ◽

And Control

Background: Leptospirosis is a zoonosis endemic in tropical climates. Though overall incidence of leptospirosis has decreased during recent years, it continues to be a major public health problem, highly underreported in India. Various trends such as seasonal, geographical, mortality have to be studied in detail for proper planning of prevention and control programs. The objective of this study was to assess geographical, seasonal, mortality trends of leptospirosis cases attending a tertiary care centre in Northern Kerala, from January 2013 to October 2019.Methods: A record-based retrospective study was conducted where leptospirosis cases attending tertiary care centre were included. Data was entered into Microsoft Excel 2007, analysed using Epi Info 7. Results were expressed as frequencies, percentages.Results: Among 647 leptospirosis cases, 141 were confirmed and 506 were probable. Maximum number of cases were reported in 2014 and maximum deaths were reported in 2019. Majority belonged to 51-60 years age category; males outnumbered females. Maximum cases were reported during September, August. Major hotspots for leptospirosis were Kannur and Taliparamba Municipalities and Koothuparamba.Conclusions: During rainy season, probably younger individuals are at risk as they indulge in leisure like swimming, playing while post rainy season older individuals are at risk due to occupational exposure. The number of deaths showed a declining trend from 2013 to 2018, but increased in 2019. Few of the previous hotspots reported decline in cases probably due to improved surveillance and control activities.

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“A STUDY OF MICROALBUMINURIA IN NON DIABETIC HYPERTENSIVE PATIENTS”

10.36106/ijar/6200318 ◽

2020 ◽

pp. 1-3

Author(s):

Anup Latne ◽

Prabhakar Jirvankar

Keyword(s):

Cardiovascular Risk ◽

Tertiary Care ◽

Public Health Problem ◽

Cross Sectional Study ◽

Low Grade ◽

Major Public Health Problem ◽

Sectional Study ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Hypertensive Patients

Hypertension is a major public health problem all over the world. The incidence of hypertension is increasing year after year and the prevalence of hypertension is increasing day by day due to increased life expectancy and aging population and their sedentary lifestyle. Hypertension is known to cause microvascular changes and increased cardiovascular risk from it. Microalbuminuria possibly reflects a state of increased renal endothelial permeability and is an easily measured marker of rather diffuse endothelial dysfunction, low grade inflammation and vascular disease burden2. Microalbuminuria has been determined as an important prognostic indicator and has been reported to be associated with increased cardiovascular risk and progressive renal damage. Reliable data on the prevalence of microalbuminuria in the general population and its association with cardiovascular risk factors is limited. Till now, there is little data available regarding screening and early treatment of hypertensive patients with microalbuminuria, as in the case of microalbuminuric non diabetic subjects. With these perspective this cross sectional study of microalbuminuria in non-diabetic hypertensive patients was undertaken to study prevalence of microalbuminuria in Non Diabetic hypertensive patients. Objectives: To determine the prevalence of microalbuminuria in non-diabetic hypertensive patients and to correlate the presence of microalbuminuria with the patients of different clinical profiles. Materials and Methods: This was observational, cross sectional study of Patients diagnosed with hypertension either admitted in ward or attending OPD of Medical College and Tertiary Care Centre. Urine microalbumin creatinine ratio was used for estimation of microalbuminuria. Conclusion: It was proved that microalbuminuria prevalence was directly proportional to the duration of hypertension, the stage of hypertension. Prevalence of microalbuminria was low in ACE inhibitor and ARB treated hypertensive patients.

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EPIDEMIOLOGICAL STUDY OF TRAUMA IN A TERTIARY CARE CENTRE IN NORTHWEST INDIA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i12.2340 ◽

2021 ◽

Vol 5 (12) ◽

Author(s):

Mohit Badgurjar ◽

Vaibhav Lakhanpal ◽

Pankaj Saxena ◽

Suman Parihar ◽

Poojan Thakor ◽

...

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Total Mortality ◽

Public Health Problem ◽

Common Mechanism ◽

Mechanism Of Injury ◽

Care Centre ◽

Tertiary Care Centre ◽

Keywords Trauma ◽

Number Of Patients

Objective: Traumatic injuries are a matter of concern worldwide. However, the rapidly changing socio economical dynamics in a developing country like India deeply influence the epidemiology behind trauma. The aim of this study was to document and analyze the epidemiological parameters and characteristics behind trauma victims admitted to our tertiary care centre. Methods: The observational study was carried out over a period of one year (January 2019 to December 2019) enrolling a total of 300 trauma patients. The age, sex, locality, delay in hospitalization, mechanism of injury, sites of injury and outcomes were documented. Results: Injuries occurred predominantly in the 20-40 age group with males being the chief victims. There was a considerable amount of delay in hospitalization ranging from one hour to more than 24 hours while only 7 patients arrived to the emergency within one hour of trauma. Vehicular trauma (54%) was the most common mechanism of injury. Injuries to the extremities (38.6%) and head (28.6%) were the most common sites. A considerable number of patients (45.3%) required care in the intensive care unit. A total of 172 patients required surgical interventions of various kinds and there was a total mortality rate of 6%. Amongst the polytrauma cases, 54 patients (81.8%) required ICU admission, 42 patients (63.6%) required surgical intervention and 6 patients (9.1%) died after admission. Conclusion: The results of this study highlight some of the problems with our existing infrastructure bringing to light the need for stricter enforcement of traffic safety laws and improvement of infrastructure particularly the roadways in rural areas as well as the referral systems. Vehicular trauma should be seen as a public health problem and appropriate interventions should be implemented. Keywords: Trauma, Road Traffic Accidents, Epidemiology, Head injuries

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Study of clinico-epidemiological profile of leprosy patients at tertiary care centre of South Gujarat region

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20201580 ◽

2020 ◽

Vol 6 (3) ◽

pp. 355

Author(s):

Kautuk K. Patel ◽

Anjum M. Momin ◽

Ankita A. Mistry ◽

Jignesh B. Vaishnani

Keyword(s):

Tertiary Care ◽

National Level ◽

Public Health Problem ◽

Warning Signs ◽

Tertiary Care Centre ◽

Female Ratio ◽

Male Female Ratio ◽

Leprosy Patients ◽

Epidemiological Profile ◽

Epidemiological Characteristics

Background: Leprosy is a chronic feared illness causes by Mycobacterium leprae. It was eliminated as a public health problem in India in 2005. But still, India contributes more than 60% of all new cases of leprosy.Methods: A retrospective analysis of 307 patients attending the leprosy clinic of the dermatology out patient department, SMIMER, was done for a period of five years from January 2014 to December 2018. The data was analysed for clinical and epidemiological characteristics of the patients.Results: A total of 307 patients visited the leprosy clinic during the study period. More than half patients (60.3%) were between 21-40 years age group. There were 213 males and 94 females with male female ratio of 2.3:1. 72.3% (222) patients were suffering from multibacillary leprosy and 27.7% (85) had paucibacillary disease. Borderline tuberculoid leprosy was the most common type found in 83 patients (27.1%). 16 cases (5.2%) of childhood leprosy (less than 14 years of age) were noted. A total of 214 patients (69.7%) were migrants.Conclusions: Despite of decline at global and national level, leprosy cases show gradual increase. The high proportion of total cases, MB cases, and grade 2 disability cases are warning signs. Continued efforts are required to manage and prevent the disease.

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Study on prevalence of hepatitis B in pregnant women and its effect on maternal and fetal outcome at tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172069 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2238

Author(s):

Sunita Mishra ◽

Priyali Purandre ◽

Ratna Thakur ◽

Shweta Agrawal ◽

Madhuri Alwani

Keyword(s):

Hepatitis B ◽

Pregnant Women ◽

Tertiary Care ◽

Mode Of Delivery ◽

Public Health Problem ◽

Pregnant Patient ◽

Control Measures ◽

Major Public Health Problem ◽

Tertiary Care Centre ◽

Vaccination Programs

Background: Hepatitis-B is caused by double stranded DNA virus. Prevalence of hepatitis B in pregnant woman worldwide is 2.5 to 1.5% whereas in India it is 2 to 7.7%.Methods: This is a retrospective study conducted at SAMC and PGI, Indore between January 2016 to December 2016. Hepatitis- B prevalence and outcome was assessed by doing routine screening of hepatitis B antigen in our indoor patients and finding out their maternal and fetal outcome.Results: Total 3567 deliveries were conducted during study period, out of them 39 were diagnosed as HbsAg positive pregnant patient; so, prevalence was found to be 1.09%. out of these, 84.6% were booked cases, mode of delivery was vaginal in 66.67% cases, preterm Delivery was in 10.26% of cases, meconium stained liquor was found in 5.13% cases, maternal mortality was nil, perinatal mortality was found in 2.56% cases and 5.13% cases were admitted in NICU.Conclusions: Screening of all pregnant women for HbsAg irrespective of risk factors will definitely help to know the correct prevalence and reduce the transmission of hepatitis B infection. Hepatitis B is a major public health problem in India and will continue to be until appropriate nationwide vaccination programs and other control measures are established.

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Dengue: experience from a tertiary care centre in Northern Karnataka, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192923 ◽

2019 ◽

Vol 7 (7) ◽

pp. 2803

Author(s):

Mohammad A. Waheed

Keyword(s):

Dengue Infection ◽

Tertiary Care ◽

Public Health Problem ◽

Febrile Illness ◽

Severe Thrombocytopenia ◽

Acute Febrile Illness ◽

Care Centre ◽

Tertiary Care Centre ◽

Old Patients ◽

Function Test

Background: Epidemiology of dengue infection is evolving, and research gap exists in the region. The clinical features, laboratory parameters, complications and treatment outcomes of patients diagnosed of dengue infection at a tertiary care centre were analysed in the present study.Methods: More than 12 years old patients, presenting with features suggestive of acute febrile illness were subjected to detailed history taking and thorough clinical examination. All the suspected cases were further evaluated with complete blood count, liver function test, kidney function test, along with ultrasonography of abdomen. Blood samples were tested for dengue antibodies (IgG and IgM) by hemagglutination inhibition method for confirmation of the diagnosis. The clinical course was closely monitored during hospital stay and complications and deaths, if any, were noted.Results: Total 140 patients were studied. Fever (100%), headache (80%) and myalgia (73.6%) were the commonest symptoms. Thrombocytopenia (136, 97.1%) was the commonest hematological finding, while severe thrombocytopenia (<50,000/cu. mm) was observed in 38 (27.1%) cases. Hepatomegaly (61, 43.6%), splenomegaly (42, 30.0%), ascites (54, 38.6%), pleural effusion and gall bladder edema (18, 12.9% each) were the commonest findings on ultrasonography. Shock and ARDS were the major complications.Conclusions: Dengue remains an important public health problem even at a tertiary care centre and strong suspicion is needed in adult patients with acute febrile illness. The management should focus on averting shock and ARDS, which would help in larger aim of reduction in mortality.

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Evaluation of pattern and prognostic factors of head injury cases in a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20201865 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1535

Author(s):

Ashish Anand ◽

Surender Verma ◽

Pradeep Garg ◽

M. Taquedis Noori ◽

Ankur Kajal ◽

...

Keyword(s):

Prognostic Factors ◽

Head Injury ◽

Alcohol Intoxication ◽

Tertiary Care ◽

Public Health Problem ◽

Final Outcome ◽

Major Public Health Problem ◽

Care Hospital ◽

Tertiary Care Centre ◽

Multimodality Approach

Background: Head injury is a major public health problem worldwide and requires appropriate attention both regionally and globally. This study was done to find the patterns and to evaluate prognostic factors for final outcome of cranio-cerebral trauma.Methods: A prospective study of 200 cases of head injury was conducted in a tertiary care hospital during one year duration. Apart from patient’s demographic profile detailed history and examination was recorded. Final outcome of all patients was noted at discharge and during follow up, various prognostic factors were studied by taking Glasgow outcome scale (GOS) at 3 months of head injury.Results: This study included 156 (78%) males and 44 (22%) females with average age of 35.95 years. Assault followed by RTI was the main cause of TBI. The factors which correlated with poor prognosis are presence of increasing age, less GCS at admission, alcohol intoxication and multiple lesions on CT scan.Conclusions: Prognostication of patients with head injury will help to provide timely multimodality approach which will ultimately help in improving outcome of these patients.

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Hepatorenal Syndrome: Are We Doing Better?

Canadian Journal of Gastroenterology ◽

10.1155/2004/707695 ◽

2004 ◽

Vol 18 (2) ◽

pp. 121-122

Author(s):

Florence Wong

Keyword(s):

Renal Failure ◽

Medical Records ◽

Hepatorenal Syndrome ◽

Multiorgan Failure ◽

Tertiary Care ◽

Alcoholic Cirrhosis ◽

Care Centre ◽

Tertiary Care Centre ◽

Predisposing Factor ◽

Common Cause

This is a retrospective study assessing the accuracy of diagnosis, clinical features and outcome of patients coded with a medical record diagnosis of hepatorenal syndrome (HRS) between 1988 and 1998 in a tertiary care centre in Canada. The authors found that, of the 46 patients whose medical records revealed a diagnosis of HRS, only 27 patients (59%) fulfilled the criteria for the diagnosis of HRS defined by the International Ascites Club (IAC) (1). Most patients with HRS were middle-aged men with decompensated alcoholic cirrhosis, jaundice and hepatic encephalopathy. Infection (48%), gastrointestinal bleeding (33%) and overly aggressive paracentesis (27%) were the major precipitants of renal failure. Once HRS developed, the mortality rate was high (93%), with multiorgan failure being the most common cause of death. The authors concluded that diagnostic accuracy is paramount for studies of HRS. In addition, decompensated alcoholic cirrhosis remains the main predisposing factor for HRS, with various other factors precipitating its development.

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Intrastromal Injection of Voriconazole in the Treatment of Deep Fungal Keratitis - A Prospective Study in a Tertiary Care Centre in South India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/285 ◽

2021 ◽

Vol 8 (20) ◽

pp. 1505-1509

Author(s):

Bindu Madhavi R ◽

Manjula Y.M ◽

Suma C ◽

Soumya Basanth ◽

Nibedita Acharya

Keyword(s):

Topical Treatment ◽

South India ◽

Tertiary Care ◽

Fungal Keratitis ◽

Antifungal Drugs ◽

Care Centre ◽

Mycotic Keratitis ◽

Tertiary Care Centre ◽

Case Series Study ◽

Intrastromal Injection

BACKGROUND Treatment of fungal ulcers is one of the most challenging tasks. Various topical antifungal drugs have poor corneal stromal penetration. Voriconazole is a broad spectrum drug and is an effective agent for the treatment of fungal keratitis as a topical preparation. It is potent against a broad range of clinically significant fungal infections both in the eye as well systemically. In tropical climatic conditions filamentous fungi commonly cause eye infections and are associated with poor visual outcomes. The treatment options for mycotic ulcers are limited, therefore direct intrastromal injections are helpful in the management of these deep mycotic keratitis. We wanted to evaluate the role of intrastromal injection of voriconazole in the management of deep fungal keratitis not responding to conventional therapy. METHODS This an interventional case series study done at a tertiary care centre in south India from the year April 2019 to August 2020. Eight eyes of eight patients with microbiologically proven deep stromal recalcitrant mycotic keratitis not responding to topical antifungal medications were evaluated. Voriconazole 50 microgram / 0.1 ml was injected around the infiltrate in the corneal stroma as an adjunctive to the topical antifungal treatment. Main outcome measure was a reduction of the size of the infiltrate and ulcer and decrease in infection on regular follow ups. RESULTS Before injecting voriconazole, all the cases were of either gradually worsening of lesions on topical treatment, or not responding to topical treatment. After the injection a rapid decrease in the size of corneal ulcer, hypopyon, and infiltration was seen within 3 weeks. CONCLUSIONS Targeted delivery of intrastromal voriconazole may be a safe and effective way in the management of deep seated fungal ulcers which respond poorly to conventional treatment procedures, thus reducing the need for further surgical treatment. KEYWORDS Intrastromal Injection, Voriconazole, Fungal Keratitis, Deep Mycotic Keratitis

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