A STUDY ON HYPONATREMIA IN CIRRHOSIS OF LIVER AND ITS PROGNOSTIC VALUE.

2021 ◽  
pp. 4-5
Author(s):  
Evuri Pramod Reddy ◽  
Pathan Fardeeba Khanam
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Hepatorenal Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Electrolyte Imbalance ◽  
P Value ◽  
High Morbidity ◽  
Care Hospital ◽  
Cirrhotic Patients

BACKGROUND: Hyponatremia is an electrolyte imbalance that commonly occurs in hospitalized patients. In cirrhotic patients with advanced stage of disease there is release of ADHthat causes impairment in renal excretion of free 2,3 water resulting in dilutional hyponatremia in combination with renal vasoconstriction.This study was taken up to nd the prevalence of the hyponatremia and association between hyponatremia and the occurrence of major complications in patients with liver cirrhosis in a tertiary care hospital. AIMS AND OBJECTIVES 1. To study the prevalence of hyponatremia in cirrhotic patients attending a tertiary care hospital. 2 To evaluate the association between hyponatremia and complications in ci . rrhosis among patients attending a tertiary care center and its prognostic signicance. METHODS: It is a cross-sectional study done in Katuri Medical College & Hospital over a period of 13 months between june 2018 to june 2019. Patients were selected based on clinical examination,biochemical tests and ultrasound abdomen and divided into three groups as those having a sodium levels of < 130, 131 to 135 and >136 meq/l and patients having sodium levels <135 meq/l were considered hyponatremic.MELD score was calculated at the time of admission. RESULTS: There was signicant difference with respect to MELD score in three groups (p value =< 0.0001) and with respect to complications of liver cirrhosis namely portal hypertension, hepatic encephalopathy ,hepatorenal syndrome CONCLUSION: Hyponatremiain cirrhosis are associated with severe complications like hepatic encephalopathy, hepatorenal syndrome and high morbidity and mortality

scholarly journals Pattern of electrolyte imbalance and their response to corticosteroid therapy in stroke patients admitted in a tertiary care hospital

2018 ◽  
Vol 28 (2) ◽  
pp. 75-80
Author(s):  
AT Islam ◽  
S Afrose ◽  
ZK Joarder ◽  
KAK Azad
Keyword(s):  
Acute Stroke ◽  
Corticosteroid Therapy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Electrolyte Imbalance ◽  
Control Group ◽  
P Value ◽  
Source Population ◽  
Care Hospital ◽  
Stroke Patients

This prospective, single center, case-control study was designed to see the response of electrolyte imbalance in admitted stroke patients receiving corticosteroid therapy in a tertiary care hospital. In IPD, still in many cases of stroke with cerebral edema, injectable corticosteroids are given frequently. Our aim was to find out the common electrolyte imbalances in different type of acute stroke, and, if there was any difference between the patterns of electrolyte imbalance in patients receiving corticosteroids for management, with those who did not receive.Methods: The source population of this study comprised stroke patients attending the DMCH, between 1st January to 30th June 2014. Total 70 patients, 35 as control and 35 as case group, who received steroids, were randomly enrolled for the study. Detail demographic data were collected from the informant was recorded in structured case report form.Result: In our study, 48 (68.55%) patients had infarction and 22 (31.45%) patients had hemorrhagic stroke. Hyponatremia was detected in majority 51 (72.85%), others imbalances are hypernatremia 9(12.85%), hypokalaemia 31(44.28%), hyperkalaemia 2(2.85%) and hypochloraemia 37(52.85%). Out of 48 ischemic stroke, hypernatraemia, hypokalaemia and hypochloraemia was present among 8(16.66%), 19(39.58%) and 24(50%) patients respectively. Out of 22 haemorrhagic stroke patients, 1(4.54%), 12(54.54%), 2(9.09%) and 13(59.09%) cases were found to have hypernatraemia, hypokalaemia, hyperkalaemia and hypochloraemia respectively. After giving injectable steroids, differences were statistically significant between two group, p-value was 0.016 (p<0.05). Among control group 24(68.57%); improvement observed was insignificant.Conclusion: It was statistically evident that, patients receiving injectable corticosteroids in acute stroke, showed improvement and had better outcome than of those who did not receive.Bangladesh J Medicine Jul 2017; 28(2) : 75-80

ASSOCIATION OF MULTI-MORBIDITIES WITH SEPSIS IN ADULT PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, KARACHI

2019 ◽  
Author(s):  
Shan-Ul-Haq Siddiqui
Keyword(s):  
Rheumatoid Arthritis ◽  
Socioeconomic Status ◽  
Chronic Diseases ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Adult Patients ◽  
P Value ◽  
High Morbidity ◽  
Care Hospital ◽  
The Mean

Background: Multi-morbid chronic diseases are increasingly placing a greater burden on individuals, communities and health care services. With advancing medical facilities, a growing proportion of the population is surviving longer with multiple chronic diseases. Sepsis is a life threatening infection with multiple organ dysfunctions leading to very high morbidity and mortality. Treating patients with multi-morbidities have always been more difficult when compared to patients with no co-morbid conditions. Hence, data from this study will empower us in exhibiting effective plans in the management of multi-morbidities with sepsis in our region. The study is aimed to determine the association of multi-morbidities with sepsis in adult patients admitted in a tertiary care hospital. Methods: This is a case-control study conducted in the Medicine Wards and Intensive Care Unit of a tertiary care hospital in Karachi during the period of May 2018 to October 2018. Results: In this study, 52 patients were enrolled. The mean age of patients was 59.35 ± 6.17. Socioeconomic Status showed significant association (p-value 0.034). The mean Sequential Organ Failure Assessment (SOFA) Score was 2.13 ± 1.86. The odds ratio of having cancer [OR: 3.10 (0.10 – 80.1), p-value 0.50] and other multimorbidities like rheumatoid arthritis [OR: 3.30 (0.30 – 33.6), p-value 0.32] in cases of sepsis respectively were more than in controls but the data was not statistically significant. The mean length of hospital stay was 4.71 ± 2.08. Conclusion: Despite our study limitations, a strong association of socioeconomic status with cases and controls in admitted patients was seen and among them, the upper income groups were the most. Although, an association of cancers and multimorbidities like rheumatoid arthritis with cases and controls has been identified, it requires to be researched further. Consensus regarding the definition of multimorbidity should be made.

scholarly journals Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1007
Author(s):  
Vijoy S. Kairi ◽  
Pinaki Chakravarty ◽  
Arun Kumar Sipani
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Case Record ◽  
Medical College ◽  
Disease Modifying ◽  
Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

scholarly journals Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Ahmad Zeeshan Jamil ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Visual Outcome ◽  
P Value ◽  
Care Hospital ◽  
Open Globe ◽  
Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods:  Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion:  Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

Spontaneous Bacterial Peritonitis in Cirrhotic Patients Hospitalized in the Tertiary Care Hospital

2011 ◽  
Vol 140 (5) ◽  
pp. S-953
Author(s):  
Arslan Kahloon ◽  
Rodjawan Supakul ◽  
Paul Y. Kwo ◽  
Raj Vuppalanchi ◽  
Marwan Ghabril ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

2019 ◽  
Vol 30 (2) ◽  
pp. 163-171
Author(s):  
Amod Tilak ◽  
Smita Shenoy ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Amruta Tripathy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
P Value ◽  
Care Hospital ◽  
Long Term Treatment ◽  
Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

scholarly journals Frequency Of Post-operative Hypocalcaemia Following Thyroid Surgery At A Tertiary Care Hospital Of Sindh

2017 ◽  
Vol 08 (01) ◽  
pp. 07-10
Author(s):  
Summaya Qazi ◽  
Khalil ahmed Almani ◽  
Rizwanullah Junaid Bhanbhro ◽  
Diya Ram Khatri
Keyword(s):  
Serum Calcium ◽  
Thyroid Surgery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Long Duration ◽  
Symptomatic Hypocalcemia ◽  
Laboratory Investigations

Objective: The present study was conducted to determine the frequency of post-operative hypocalcaemia following thyroid surgery at a tertiary care hospital of Sindh Study design: Observational study Place and Duration: Department of surgery, Isra University Hospital from December 2014 to July 2017. Materials and Methods: 100 cases of thyroid swellings were selected according to inclusion and exclusion criteria. Pre- operative patient history, physical examination, thyroid gland examination and laboratory investigations were performed. A serum calcium levels <8 mg/dl was taken as hypocalcemia. Data was analyzed on SPSS 21 version and P value (P< 0.05) was considered significant. Results: Of 100 patients, 67% were female and 33% were male (P=0.0001). Female dominancy was noted with female to male ratio of 2.03:1. Age (mean± SD) was noted as 37.5 ± 9.5 years (19 – 48 years). Frequency of symptomatic hypocalcaemia was noted in 23% subjects post operatively. Mean± SD serum calcium and phosphate in post operative hypocalcemia subjects was noted as 7.31 ± 0.38 mg/dl and 2.95 ± 0.63 mg/dl respectively. Majority of symptomatic hypocalcemia were noted within 72 hours post operatively. Conclusion: The present study reports 23% frequency of post thyroidectomy hypocalcemia noted within 72 hours post operatively. Goiters of long duration, recurrent goiters, hyperthyroidism and goiters with retro sternal extensions were found risk factors for the post thyroidectomy hypocalcemia.

scholarly journals Prevalence and determinants of hypertension and diabetes mellitus in an urban area of Coimbatore

2020 ◽  
Vol 7 (5) ◽  
pp. 1807
Author(s):  
Naveen Prabhu Jayaraj ◽  
Jeevithan Shanmugam ◽  
Shanmugapriya Duraisamy ◽  
Loganathan Padmavathy
Keyword(s):  
Diabetes Mellitus ◽  
Life Style ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Vegetarian Diet ◽  
High Morbidity ◽  
Care Hospital ◽  
Elderly Age ◽  
Field Practice ◽  
Sedentary Life Style

Background: Owing to change in behavior and lifestyle patterns, diabetes mellitus and hypertension are in increasing trend worldwide. They are associated with various complications resulting in high morbidity. Early detection of these would necessitate the prevention of complications associated with it and improves the quality of life of the people. The objective of the study was to assess the prevalence and determinants of diabetes mellitus and hypertension among urban population in the field practice area of a tertiary care hospital in Coimbatore.Methods: 299 individuals of both sexes belonging to six wards in the field practice area of a tertiary care hospital in Coimbatore were randomly selected and screened for diabetes mellitus and hypertension. Diagnosis was based on American Diabetic Association and JNC 7 guidelines for diabetes mellitus and hypertension respectively. Data on various factors associated was collected using pretested validated semi structured questionnaire.Results: Overall prevalence of diabetes mellitus and hypertension was found to be 32.44% and 38.8% respectively with newly diagnosed diabetes mellitus and hypertension of 4.02% and 7.37%. Overall adherence was found to be 80%. Factors such as elderly age, sedentary life style, non-vegetarian diet, obesity are found to be associated with both diabetes mellitus and hypertension.Conclusions: Almost one in every third person found to be having either diabetes mellitus/hypertension or both with 20% non-adherence to treatment. This high prevalence necessitates the need for adoption of various strategies to combat the risk factors and to promote healthy life style.

scholarly journals Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Nighat Sultana ◽  
Attia Bari ◽  
Mehwish Faizan ◽  
Muhammad Sarwar
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Tetanus ◽  
P Value ◽  
Care Hospital

Objective: To determine the prognostic factors and outcome of tetanus in children of post-neonatal age admitted in the intensive care unit (ICU) of a tertiary care hospital. Methods: This prospective cross sectional study, carried out in the Pediatric ICU of The Children’s Hospital Lahore from Jan 2013 to March 2017. Children of both genders with age range of two months to 16 years diagnosed clinically as tetanus were included. All 132 patients were scrutinized for all possible risk factors, need for mechanical ventilation and outcome. Data was analyzed by SPSS version 20. Results: Mean age of children was 7.5±3.4 years with male predominance (70.5%). Only (38.6%) received three doses of vaccination but none had booster dose. Trauma (43.2%) encompassed maximum predisposing factor followed by ear or nose prick and ear discharge. Mean duration of ICU stay was 20±13.3 days. Mortality rate was (17.4%). Ventilator support was given to (78.8%). Neurological outcome was normal in (82.6%). Trauma, ear or nose prick in girls and ear discharge were significantly associated with poor outcome and death with p-value of <0.001, 0.011 and <0.001 respectively. Other factors associated with poor outcome were need for mechanical ventilation and neurological impairment with p-value of 0.001 and <0.001 respectively. Conclusion: Tetanus is causing our children to suffer from devastating disease. Vaccination status is not satisfactory and along with trauma, ear discharge and ear or nose prick are identifiable risk factors. To combat these issues large scale vaccination and booster doses remains promising option. doi: https://doi.org/10.12669/pjms.35.5.656 How to cite this:Sultana N, Bari A, Faizan M, Sarwar M. Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.656 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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