“TO STUDY THE CLINICAL PROFILE AND UTILITY OF FIBER-OPTIC BRONCHOSCOPY IN SUSPECTED CASES OF NON RESOLVING PNEUMONIA IN IDENTIFYING ITS ETIOLOGY AT TERTIARY HEALTH CARE CENTRE”

2021 ◽  
pp. 20-22
Author(s):  
Jaypal Singh Chahar ◽  
Naik Pankti S ◽  
Daxini Arvind B ◽  
Agrawal Bhavika
Keyword(s):  
Diagnostic Yield ◽  
Past History ◽  
Tertiary Care ◽  
Fiberoptic Bronchoscopy ◽  
Care Hospital ◽  
Comorbid Conditions ◽  
Health Care Centre ◽  
Great Utility ◽  
Disease Condition ◽  
Diagnostic Modalities

Introduction- Non-resolving pneumonia is always a challenging clinical scenerio where Various diagnostic modalities are greatly required to reach the diagnosis. We aimed to study The role of beroptic bronchoscopy in non-resolving pneumonia along with the various comorbidities associated with the disease condition. Methodology- A prospective observative study in a tertiary care hospital was undertaken. A total of 40 patients diagnosed with non-resolving pneumonia were recruited for diagnostic beroptic bronchoscopy. Results- The overall diagnostic yield of beroptic bronchoscopy in non-resolving pneumonia was 87.5%. The causes of non-resolving pneumonia were Tuberculosis(22.5%), bacterial pneumonia(45%), malignancy(15%), fungal pneumonia(5%). 12.5% patients were undiagnosed. Patients had a signicant past history which also revealed associated comorbid conditions. Diabetes(14(33%)) and COPD(11(27.5%)) were leading comorbid conditions. Conclusion- Fiberoptic Bronchoscopy is a great utility tool in reaching the diagnosis in patients with non-resolving pneumonia.

Diagnostic yield of Archer FusionPlex PanHeme and solid panels: two-year experience from a pediatric tertiary care hospital

2021 ◽  
Vol 132 ◽  
pp. S39-S40
Author(s):  
Kathleen Schieffer ◽  
Eileen Stonerock ◽  
Vijayakumar Jayaraman ◽  
Heather Jenkins ◽  
Tim Peterson ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals ANTIMICROBIAL-RELATED ADVERSE DRUG REACTION IN A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 10 (8) ◽  
pp. 229
Author(s):  
Jindal M ◽  
Sharma Rk
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Spontaneous Reporting ◽  
Tertiary Care Hospital ◽  
Past History ◽  
Tertiary Care ◽  
Care Hospital ◽  
Beta Lactam ◽  
Active Monitoring ◽  
Beta Lactam Antibiotics

  Objective: The objective of the study was to evaluate the adverse drug reaction (ADR) related to commonly used antimicrobials in a tertiary care hospital.Methods: A prospective spontaneous reporting study involving, active methods (pharmacist actively looking for suspected ADRs) and passive methods (stimulating prescribers to report suspected ADRs) was carried out in all departments of a tertiary care hospital, for 1 year. Patients of all age groups were included in the study. The data for the study were taken from case sheets, investigation reports of patients who had experienced an ADR, personal interviews with reporting persons or clinicians, personal interviews with patient or patient’s attendant, past history of medication use, which were generally obtained from, prescriptions from the past, reports of medical and surgical interventions, referral letters, ADR reporting forms. Collected data were then analyze for causality assessment by Naranjo’s scale and severity assessment by Hartwig and Siegel’s scale.Result: During 1 year of study period, 75 ADRs related to antimicrobial were reported among 1354 patients who were given antibiotic for the treatment. The incidence rate of antibiotic was found to be 5.53%. The department that reported ADR was medicine (10.16%), ENT (4.6%), pediatric (8.12%), orthopedics (06.9%), surgery (06.9%), chest and tuberculosis (04.6%), obstetrics and gynecology (06.9%), dentistry (02.3%), and skin (10.16%). The most common ADRs were related to gastrointestinal tract; dermatological reactions were second in the list of antimicrobial drugs causing ADR. In this study, among antimicrobials, fluoroquinolones, and beta-lactam antibiotics were the most common drugs causing gastrointestinal and dermatological ADRs. There was no unknown ADR reported that may need to be further investigated through active monitoring. All patients recovered from ADRs without any complications. The causality was assessed by Naranjo’s scale and it revealed that out of 75 antibiotics related ADR 48 (64%) were possible, 27 (36%) were probable, 3 (4.00%) were definate, and 0% were unlikely. According to the Hartwig and Siegel’s scale, most of ADR were mild 45 (60%) and moderate 30 (40%) in nature.Conclusion: ADRs related to antimicrobials occurs frequently. Among antimicrobials, fluoroquinolones, and beta-lactam antibiotics were the most common drugs causing gastrointestinal and dermatological ADRs. The health-care system can promote the spontaneous reporting of antimicrobial ADR to pharmacovigilance center for ensuring safe drug use and patient care.

scholarly journals Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center

2021 ◽  
Author(s):  
Tilak TVSVGK ◽  
Ajay Handa ◽  
Kishore Kumar ◽  
Deepti Mutreja ◽  
Shankar Subramanian
Keyword(s):  
Observational Study ◽  
Pulmonary Toxicity ◽  
Imaging Finding ◽  
Tertiary Care ◽  
Case Series ◽  
Fiberoptic Bronchoscopy ◽  
Chemotherapeutic Agents ◽  
New Drugs ◽  
Care Hospital ◽  
Persistent Symptoms

Abstract Background Pulmonary toxicity due to chemotherapeutic agents can occur with many established and new drugs. Strong clinical suspicion is important as the clinical presentation is usually with nonspecific symptoms like cough, dyspnea, fever, and pulmonary infiltrates. Timely discontinuation of the offending agent alone can improve the condition. Methods A prospective observational study on patients receiving chemotherapy at an 800-bedded tertiary care hospital was performed from 2014 to 2016. Consecutive patients on chemotherapy, presenting with nonresolving respiratory symptoms were evaluated with contrast-enhanced computerized tomography of chest, diffusion lung capacity for carbon monoxide (DLCO), fiberoptic bronchoscopy with lavage, and biopsy, after excluding all causes for pulmonary infections. Descriptive data has been depicted. Results A total of 18 patients were evaluated for persistent symptoms of dry cough, dyspnea, and fever among 624 who received chemotherapy during the study period. Ground-glass opacities on high-resolution CT was the most common imaging finding, others being patchy subpleural consolidation and pleural effusion. Lymphocyte-predominant bronchoalveolar lavage was detected in nine. Eight of the 15 patients who underwent DLCO, had abnormal results. Seven had significant histopathological findings on bronchoscopic lung biopsy, which revealed organizing pneumonia as the most common pattern. Paclitaxel, fluorouracil, gemcitabine, and tyrosine kinase inhibitors were the common culprit drugs. Discontinuation alone of the culprit drug was effective in 15 and 3 needed oral corticosteroids for relief of symptoms. None of the patients died due to the toxicity. Conclusion An incidence of 2.8% for chemotherapy-induced lung injury was seen in our observational study of 3 years, with parenchymal, interstitial, and pleural involvement due to various chemotherapeutic agents. Oral steroids maybe required in a subset of patients not responding to discontinuation of the culprit agent.

scholarly journals Clinical trends of scalp alopecia areata: a tertiary care hospital based observational study

2020 ◽  
Vol 6 (2) ◽  
pp. 193
Author(s):  
Pallavi Singh ◽  
Milind A. Patvekar ◽  
Bhavika Shah ◽  
Alisha Mittal ◽  
Asmita Kapoor
Keyword(s):  
Family History ◽  
Observational Study ◽  
Alopecia Areata ◽  
Tertiary Care Hospital ◽  
Past History ◽  
Tertiary Care ◽  
Disease Onset ◽  
Epidemiological Data ◽  
Care Hospital ◽  
History Of

<p class="abstract"><strong>Background:</strong> Alopecia areata is one of the commonest types of non-scarring alopecia involving the scalp and/or body. As there is paucity of recent epidemiological data from our country, this study was conducted to determine the latest clinical and epidemiological trends of scalp alopecia areata.</p><p class="abstract"><strong>Methods:</strong> A hospital-based observational study consisting of 100 cases of clinically diagnosed scalp alopecia areata who reported to the Dermatology OPD, Dr. D.Y. Patil Medical College, Pune, was conducted for a period of six months. Socio-demographic and clinical information was collected and clinical examination was performed on all patients. The data was evaluated using appropriate statistical methods.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of the 100 cases enrolled, males (64%) outnumbered females (36%). The commonest presenting age group was 21-30 years (44%). Disease onset was sudden in 80% patients and 59% cases had a progressive disease course. Majority (75%) had a disease duration of less than 3 months. Majority cases were asymptomatic (80%) with no precipitating factors (90%). Past history and family history of alopecia areata were present in 13% and 9% cases, respectively. Personal and family history of associated diseases were present in 27% and 22% patients, respectively. Most patients had single (61%), patchy (83%) lesions with occiput (45%) being the commonest initial site. Nail changes were present in 22% cases, of which pitting (13%) was the commonest nail finding.</p><p class="abstract"><strong>Conclusions:</strong> This study reflects the clinical profile of scalp alopecia areata in a tertiary care hospital.</p>

scholarly journals Study of clinical profile of cervical cancer patients: a hospital based study

2017 ◽  
Vol 6 (11) ◽  
pp. 4873
Author(s):  
Preeti Umate ◽  
Dhuldev S. Thengal ◽  
Dhundiraj Kurdukar
Keyword(s):  
Early Stage ◽  
Past History ◽  
Clinical Stage ◽  
Tertiary Care ◽  
Cost Effective ◽  
Educational Status ◽  
Clinical Staging ◽  
Common Symptom ◽  
Care Hospital ◽  
Quality Cancer Care

Background: As a consequence of growing and ageing populations, developing countries are disproportionately affected by the increasing number of cancers. Though the situation in India is gradually improving there still exists a disparity between the availability of quality cancer care. With this view, the present study was planned to undertake in this tertiary care institute to find out symptoms, clinical staging, complications and management of cases of carcinoma of cervix.Methods: This was a prospective observational study of carcinoma of cervix carried out at a tertiary care hospital catering services to the people of Maharashtra and neighbouring states. A thorough history including presenting complaints, demographic details, educational status and occupational details, details of menstrual and obstetric history along with any significant past history were recorded on a standard proforma.Results: Most common symptom was per vaginal bleeding which was found in 29 (69.04%). In the present study almost two third of cases i.e. 28 (66.6%) had advanced stage (IIB, III, IV) at the time of admission while the number of cases diagnosed at early stage were only 14 (33.3%). For Wertheim’s hysterectomy, most commonly used approach was transperitoneal 08 (61.53%) while 05 (38.46%) were operated by extraperitoneal approach. Pelvic lymph nodes were positive in 03 (23.07%).Conclusions: A high proportion of patients presented in stages III and IV. This emphasizes the need for early detection of Gynecological cancers in our population. Accordingly, the importance of detection of the pre-clinical stage of the diseases by considering the possibility of initiating cost-effective screening measures needs to be emphasized. 

scholarly journals In Vitro Chloroquine Resistance in Plasmodium falciparum Isolates from Tertiary Care Hospital

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Fatima Shujatullah ◽  
Haris M. Khan ◽  
Abida Khatoon ◽  
Parvez A. Khan ◽  
Mohammad Ashfaq
Keyword(s):  
Tertiary Care ◽  
Cost Effective ◽  
Diagnostic Techniques ◽  
Chloroquine Resistance ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Block Transmission ◽  
Development Of Resistance ◽  
Diagnostic Modalities

Chloroquine (CQ) has been the mainstay of treatment of malaria for decades. This cost-effective and safe drug has become ineffective for treatment of falciparum malaria in many parts of the world due to development of resistance by the parasite. In addition CQ is not gametocytocidal for P. falciparum and thus cannot block transmission. The extent of problem of chloroquine resistance in P. falciparum is increasing every year. The study was done in period of 2 years. A total of 5653 specimens were examined for malarial infection by employing different diagnostic modalities. Four hundred and thirty-five were found to be positive for P. falciparum by using different diagnostic techniques. All positive specimens were cultured on RPMI 1640 medium; only 108 were found to be culture positive. Sensitivity of isolates to chloroquine was done using Mark III WHO sensitivity plates. The prevalence of malaria infection was found 9.54% in 2010. There were schizont formation at 8 pmol/liter or more of chloroquine concentration in 26 isolates. The emergence of chloroquine (CQ) resistance pattern in Aligarh isolates increases. Antimalarial agents should be used with caution; monotherapies should be avoided.

Maternal and perinatal outcomes in cases of antepartum haemorrhage: a 3-year observational study in a tertiary care hospital

2017 ◽  
Vol 6 (3) ◽  
pp. 1025
Author(s):  
Sunil Kumar Samal ◽  
Setu Rathod ◽  
Reddi Rani ◽  
Seetesh Ghose
Keyword(s):  
Observational Study ◽  
Tertiary Care ◽  
Previous History ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Health Care Centre ◽  
Antepartum Haemorrhage ◽  
Gandhi Medical College ◽  
Associated Risk Factors

Background: The leading cause of maternal mortality in world is obstetric haemorrhage. Antepartum haemorrhage (APH) is defined as bleeding from or into the genital tract after 28weeks of pregnancy and before delivery of the baby. The aim of the present study is to study the demographic profile, type of antepartum haemorrhage (APH), maternal and perinatal complications in cases of APH and to formulate preventive guidelines so as to reduce maternal and perinatal complications in cases of APH.Methods: The study was a retrospective observational study conducted in Mahatma Gandhi Medical College & Research Institute, Pondicherry from November 2013- October 2016 [3 years]. Cases of pregnancy complicated with APH were taken. Cases with bleeding before 28 weeks and after delivery of the baby were excluded. Data collected from the records present in Labour ward complex and Medical record section.  Statistical analysis done by using SPSS software version 21.Results: Total 218 cases were presented with APH and the incidence was 2.9%. Among these 49.5% were Placenta Praevia, 42.2% were abruption placentae, 6.8% cases were indeterminate (3 cases of vasa praevia and 12 cases of excessive show) and 1.5% cases were of extraplacental cause(Local causes). Most cases were multipara with most common age group was 26-30 years (42.2%). Pregnancy in most of the cases was terminated during 34-36+6 weeks of gestation (73.0%). Most common associated risk factors found were previous caesarean section, preeclampsia, previous history of curettage, malpresentation and anaemia. Postpartum haemorrhage was found in 42.2% cases while in 4 cases peripartum hysterectomy done. Most common perinatal complications were due to low birth weight (66.5%).Conclusions: The morbidity and mortality in pregnancies complicated with APH can be achieved by early diagnosis, proper antenatal planning and terminating the pregnancy in a well-equipped tertiary health care centre.

You can't pay me to quit: the failure of financial incentives for smoking cessation in head and neck cancer patients

2016 ◽  
Vol 130 (3) ◽  
pp. 278-283 ◽  
Author(s):  
A Ghosh ◽  
G Philiponis ◽  
A Bewley ◽  
E R Ransom ◽  
N Mirza
Keyword(s):  
Smoking Cessation ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Financial Incentives ◽  
Past History ◽  
Tertiary Care ◽  
High Risk Population ◽  
Care Hospital ◽  
Incentive Group

AbstractObjective:A prospective randomised study was conducted at a tertiary care hospital to evaluate the effects of financial incentives for smoking cessation targeted at a high-risk population.Methods:Patients with a past history of head and neck cancer were voluntarily enrolled over a two-year period. They were randomised to a cash incentives or no incentive group. Subjects were offered enrolment in smoking cessation courses. Smoking by-product levels were assessed at 30 days, 3 months and 6 months. Subjects in the incentive group received $150 if smoking cessation was confirmed.Results:Over 2 years, 114 patients with an established diagnosis of head and neck cancer were offered enrolment. Twenty-four enrolled and 14 attended the smoking cessation classes. Only two successfully quit smoking at six months. Both these patients were in the financially incentivised group and received $150 at each test visit.Conclusion:Providing a financial incentive for smoking cessation to a population already carrying a diagnosis of head and neck cancer in order to promote a positive behaviour change was unsuccessful.

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