scholarly journals A retrospective study on the clinico-demographic profile of multiple sclerosis patients in various tertiary care hospitals in Mangalore city of South India

2021 ◽  
Vol 20 (3) ◽  
pp. 349-355
Author(s):  
Nitin Joseph ◽  
◽  
Rachel Melissa Salins ◽  
Priyanka Ramesh ◽  
Narayana Venkatesh Krishna ◽  
...  
Keyword(s):  
Management Practices ◽  
Late Onset ◽  
Tertiary Care ◽  
Sensory System ◽  
Oligoclonal Bands ◽  
Common Symptom ◽  
System Involvement ◽  
Clinical Presentations ◽  
Vitamin D Levels ◽  
Multiple Sclerosis Patients

Objectives. To study the risk factors, clinical presentations, course of the disease, investigations and management practices in MS. Materials and methods. Records of 23 patients diagnosed with MS using the McDonald diagnostic criteria were analysed. Outcomes. The mean age at diagnosis was 34.6±17.1 years. 17 (73.9%) patients were females. Early and late onset MS were present among 2 (8.7%) and 4 (17.4%) patients respectively. The most common symptom at diagnosis was paraesthesia [9 (39.1%)]. Motor symptoms and sensory symptoms at the time of diagnosis were present among 9(39.1%) patients each. 20 (87%) patients had motor system involvement, 9 (39.1%) had sensory system involvement, 12 (52.2%) had cranial nerve involvement, 4 (17.4%) had sphincter dysfunction and 2 (8.7%) had cerebellar involvement. Relapsing and remitting MS (RRMS) were present among 18 (78.3%) patients. Oligoclonal bands were present among 17 (73.9%) patients. Vitamin D levels in the blood were found deficient among 4 (80%) out of 5 patients with available reports of the same. Juxtacortical region was the most common [9 (39.1%)] site of involvement. Steroids were used for management among majority [12 (52.2%)] of the patients. Non-pharmacological methods for management constituted only physiotherapy which was advised among 13 (56.5%) patients. Improvement in treatment outcome were seen among 19 (82.6%) patients. Conclusions. Almost three fourth of the patients were females. RRMS was the most common course of the disease. Juxtacortical region was the most common site involved. Steroids were most commonly used for management. More non-pharmacological methods need to be introduced for MS management.

scholarly journals Multiple Sclerosis Patients with Markedly Low Intrathecal Antibody Response in Sri Lanka

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
S. M. K. Gamage ◽  
I. Wijeweera ◽  
S. B. Adikari ◽  
Katharina Fink ◽  
Jan Hillert ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Antibody Response ◽  
Clinical Presentation ◽  
Oligoclonal Bands ◽  
Sri Lankan ◽  
Clinical Presentations ◽  
Relapsing Remitting ◽  
Spectrum Disorders ◽  
Multiple Sclerosis Patients ◽  
Aqp4 Antibody

Multiple sclerosis (MS) is a heterogeneous disease which is poorly studied in Asia, where the disease is known to be rare with significant differences in clinical and radiological presentations and intrathecal antibody response. Therefore the objective of this study was to determine clinical presentation, radiological and neurophysiological characteristics, and oligoclonal band status in Sri Lankan MS patients, following careful exclusion of patients with neuromyelitis optica spectrum disorders and other conditions mimicking multiple sclerosis. Sixty-nine MS patients were recruited to the study adhering to McDonald 2010 criteria. Their clinical presentation, characteristics of central nervous system lesions in magnetic resonance imaging, visual evoked potential (VEP) results, oligoclonal bands (OCB), and AQP4 antibody status were studied. Of 69 MS patients, 54%, 6%, and 1% were relapsing remitting, secondary progressive, and primary progressive, respectively, and 39% were patients with clinically isolated syndrome. The commonest clinical presentations were cerebral motor followed by cerebral sensory and optic neuritis. Majority had typical periventricular and infratentorial lesions in MRI. Though not clinically apparent, bilateral delay of P100 wave latency was present in 52%. OCB positivity was 42% and AQP4 antibody was positive in only one patient. In conclusion, this group of Sri Lankan MS patients shares most of the clinical and radiological features of Caucasian MS patients. However, the OCB positivity is lower in this group, when compared to the Caucasian MS populations.

Role of Vitamin-D Deficiency in Term Neonates with Late-Onset Sepsis: A Case–Control Study

2019 ◽  
Vol 65 (6) ◽  
pp. 609-616 ◽  
Author(s):  
Amit Agrawal ◽  
Aekta Gupta ◽  
Jyotsna Shrivastava
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Case Control Study ◽  
Late Onset ◽  
Tertiary Care ◽  
Case Control ◽  
Term Neonates ◽  
Late Onset Sepsis ◽  
Vitamin D Levels ◽  
Control Study

Abstract Objective To find the relationship between vitamin-D levels and late-onset sepsis (LOS) in term neonates. Methods This case–control study was conducted in neonatal intensive care unit of a tertiary care teaching institution in central India. Full-term neonates with culture-proven LOS were taken as cases. Maternal and neonatal demography, clinical examination and investigations were recorded. Correlation of vitamin-D deficiency (<20 ng/ml) with LOS was assessed. Results Total 225 term neonates including 175 cases and 50 controls were included. Maternal and neonatal demographic profile was comparable. The mean vitamin-D level in cases (12.28 ± 6.11 ng/ml) was significantly lower than that in controls (14.88 ± 7.2 ng/ml) (p = 0.002). Total 151 (86.29%) neonates out of 175 cases and 37 (74%) out of 50 controls had the vitamin-D deficiency (p = 0.00003). On multiple regression analysis, neonatal sepsis (p = 0.00003) was found to be significantly associated with vitamin-D deficiency. Conclusion This study shows that vitamin-D deficiency in term neonates may predispose them to LOS.

A Study on Clinical Presentations of Oral Cancer at Tertiary Care Hospital, Bellary, Karnataka

2012 ◽  
Vol 3 (7) ◽  
pp. 1-3
Author(s):  
Dr Govindaraja Dr Govindaraja ◽  
◽  
Dr Jashvanth Dr Jashvanth ◽  
Dr Murali Krishna ◽  
Dr Kasa Somasekhar ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Clinical Presentations

Epidemiology and clinical outcome of ventilator-associated events at a tertiary care hospital from North India

2020 ◽  
pp. 004947552098245
Author(s):  
Pooja Kumari ◽  
Priya Datta ◽  
Satinder Gombar ◽  
Deepak Sharma ◽  
Jagdish Chander
Keyword(s):  
Mechanical Ventilation ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Control Measures ◽  
North India ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Utilisation Rate

The aim of our study was to determine the incidence, microbiological profile, risk factors and outcomes of patients diagnosed with ventilator-associated events in our tertiary care hospital. In this prospective study, intensive care patients put on mechanical ventilation for >48 h were enrolled and monitored daily for ventilator-associated event according to Disease Centre Control guidelines. A ventilator-associated event developed in 33/250 (13.2%); its incidence was 3.5/100 mechanical ventilation days. The device utilisation rate was 0.86, 36.4% of patients had early and 63.6% late-onset ventilator-associated pneumonia whose most common causative pathogen was Acinetobacter sp. (63.6%). Various factors were significantly associated with a ventilator-associated event: male gender, COPD, smoking, >2 underlying diseases, chronic kidney disease and elevated acute physiological and chronic health evaluation II scores. Therefore, stringent implementation of infection control measures is necessary to control ventilator-associated pneumonia in critical care units.

Vitamin D Levels, APOE Allele, and MRI Volumetry Assessed by NeuroQuant in Norwegian Adults with Cognitive Symptoms

2021 ◽  
Vol 79 (1) ◽  
pp. 311-321
Author(s):  
Jelena Zugic Soares ◽  
Renate Pettersen ◽  
Jūratė Šaltytė Benth ◽  
Karin Persson ◽  
Carsten Strobel ◽  
...  
Keyword(s):  
Vitamin D ◽  
Late Onset ◽  
Apoe Genotype ◽  
Serum Levels ◽  
Grey Matter Volume ◽  
Cognitive Symptoms ◽  
Cross Sectional ◽  
Brain Volumes ◽  
Vitamin D Levels ◽  
Mri Volumetry

Background: Allele ɛ4 of the apolipoprotein (APOE ∈4) gene is the strongest known genetic risk factor for late-onset sporadic Alzheimer’s disease. A possible relationship between vitamin D and APOE is not yet clear. Objective: In this exploratory, cross-sectional study, we examined the association between serum levels of 25-hydroxyvitamin D [25(OH)D] and brain volumes and the associations of both serum levels of 25(OH)D and APOE polymorphism to brain volumes in 127 persons (mean age 66 years) with cognitive symptoms. Methods: All subjects were examined with fully automated software for MRI volumetry, NeuroQuant. Results: After adjustment for relevant covariates, higher serum 25(OH)D levels were associated with greater volumes of cortical gray matter on both left (p = 0.02) and right (p = 0.04) sides. When both 25(OH)D levels and APOE genotype were used as the main covariates, no significant associations were found between vitamin D level and brain volume in any of the 11 brain regions. In adjusted models, only homozygous but not heterozygous APOE ∈4 allele carriers had significantly larger inferior lateral ventricles (p = 0.003) and smaller hippocampal volume (p = 0.035) than those without ɛ4. Homozygous APOE ∈4 carriers also had significantly higher vitamin D levels (p = 0.009) compared to persons without the APOE ∈4 allele. Conclusion: Higher vitamin D levels might have a preserving effect on cortical grey matter volume.

scholarly journals Comparison of Antioxidant Status and Vitamin D Levels between Multiple Sclerosis Patients and Healthy Matched Subjects

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ehsan Hejazi ◽  
Reza Amani ◽  
Naser SharafodinZadeh ◽  
Bahman Cheraghian
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Dietary Intake ◽  
Antioxidant Status ◽  
Sun Exposure ◽  
Total Antioxidant Status ◽  
Serum Levels ◽  
Study Groups ◽  
Vitamin D Levels ◽  
Multiple Sclerosis Patients

Objective. The aim of the present study was to compare the serum levels of total antioxidant status (TAS) and 25(OH) D3 and dietary intake of multiple sclerosis (MS) patients with those of normal subjects.Method. Thirty-seven MS patients (31 women) and the same number of healthy matched controls were compared for their serum levels and dietary intake of 25(OH) D3 and TAS. Sun exposure and the intake of antioxidants and vitamin D rich foods were estimated through face-to-face interview and food frequency questionnaire.Results. Dietary intake of antioxidants and vitamin D rich foods, vitamin C, vitamin A, and folate was not significantly different between the two groups. There were also no significant differences in the mean levels of 25(OH) D3 and TAS between the study groups. Both groups had low serum levels of 25(OH) D3 and total antioxidants.Conclusion. No significant differences were detected in serum levels and dietary intake of vitamin D and antioxidants between MS patients and healthy controls. All subjects had low antioxidant status and vitamin D levels.

Diversity and Prevailing Antimicrobial Resistance in Blood Stream Pathogens at NICU of a Tertiary Care Institute in Kolkata

2021 ◽  
Vol 8 (14) ◽  
pp. 854-860
Author(s):  
Nandita Pal ◽  
Sanat Kumar Dolui ◽  
Bhuban Majhi ◽  
Manisha Das
Keyword(s):  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Klebsiella Pneumoniae ◽  
Late Onset ◽  
Tertiary Care ◽  
Burkholderia Cepacia Complex ◽  
Multi Drug Resistance ◽  
Coagulase Negative Staphylococcus ◽  
Neonatal Septicaemia ◽  
Early Onset Sepsis

BACKGROUND Septicaemia is a leading cause of morbidity and mortality in neonates. Antimicrobial prescription for neonatal septicaemia (NS) should be wisely used depending on the regional spectra of infecting microbes and their antimicrobial resistance (AMR) patterns which vary over time, place and host factors. METHODS This was a descriptive cross-sectional study conducted from January 2017 to June 2017 among 102 cases of NS admitted in neonatal intensive care units (NICU). Demographic data of the concerned neonates was collected through a predesigned checklist. Blood collected from neonates was processed for culture and sepsis screen. Antimicrobial susceptibility testing was performed for the cultured isolates and phenotypic AMR patterns were observed. RESULTS Most of the studied neonates had subnormal birth weight (86). Blood culture showed predominance of gram-negative bacilli (GNB) among which Klebsiella pneumoniae was the most common followed by Burkholderia cepacia complex. Coagulase negative staphylococcus species (CoNS) was most numerous among the cultured gram-positive cocci (GPC). Candidemia of late onset was confirmed in 25 neonates. Early onset sepsis was predominantly caused by GNB (29 / 31) predominated by Klebsiella pneumoniae. Multi drug resistant (MDR) pathogens viz., extended spectrum beta-lactamase (ESBL) producing GNB, carbapenem resistant-GNB (CR-GNB) and methicillin resistant staphylococcus (MRS) phenotypes were notably prevalent. CONCLUSIONS Multidrug resistant microorganisms are notably prevalent in neonatal septicaemia. In clinically suspected very sick septicaemic neonates not showing much improvement with guideline-led empirical antimicrobial therapy, an early antibiogram guided change over to meropenem and amikacin or even to colistin in case of reported carbapenem resistance, is highly recommended. KEYWORDS Antimicrobial Resistance, Blood Culture, Multi Drug Resistance, Neonatal Septicaemia

MO515CONSTIPATION IN CHRONIC KIDNEY DISEASE: PREVALENCE AND RISK FACTORS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sourabh Sharma ◽  
Neha Sharma ◽  
Kailash Sharma
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Functional Constipation ◽  
Common Symptom ◽  
Psychological Burden ◽  
Ckd Stage ◽  
Stool Form ◽  
Rome Iv

Abstract Background and Aims Among various gastrointestinal disorders, constipation is one of the most common symptom in chronic kidney disease (CKD). However it is often neglected by nephrologists as self-limiting condition. Constipation impacts quality of life in multiple ways and increases socio-psychological burden. Constipation and associated risk factors have been poorly studied and most studies are retrospective. Method We enrolled CKD stage 3 to 5 patients on regular follow-up with nephrologist from June 2018 to June 2020, at a tertiary care centre in North India. Constipation was defined using Rome IV criteria (Functional constipation) which is composed of six constipation related symptoms, and diagnosis of constipation is established by presence of two or more symptoms for at least 3 months. Patients were also asked to maintain a 7 day prospective stool diary. It consisted of seven day written prospective chart of stool form and frequency. Patients were instructed to record when each bowel movement happened and to mark stool form type for each movement as described in words and pictures on Bristol Stool Form Scale (BSFS). Opioid induced constipation was defined as per Rome IV criteria. The diagnostic criteria is similar to functional constipation, but with requisite that new or worsening symptoms occurred when initiating, changing or increasing opioid therapy. Results Two hundred twenty five patients were studied out of which 59 (26.2%) patients were in CKD stage3, eighty one (36%) patients were in CKD stage4 and 85 (37.8%) patients were in stage5. Out of 85 CKD stage5 patients, 23 (27%) were on dialysis. Mean age of patients was 49.1 years. Out of 225 patients, 135 (60%) were male. Constipation symptoms and diagnosis reported in each stage has been depicted in Table 1. Clinical correlates of constipation has been depicted in Table 2. Conclusion Constipation measured using Rome IV criteria affects around two-third of CKD stage 3-5 patients. Diabetes, hypertension and opioid use has been found to be significantly associated with constipation.

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