scholarly journals Evaluation of Lactate in Differentiating Pyogenic and Non-Pyogenic Meningitis

2020 ◽  
Vol 3 (2) ◽  
pp. 37-41
Author(s):  
Mehul K. Patel ◽  
Hitesh J. Patel
Keyword(s):  
Statistical Significance ◽  
Care Hospital ◽  
Pyogenic Meningitis ◽  
Tubercular Meningitis ◽  
Mortality And Morbidity ◽  
Glucose Ratio ◽  
Csf Lactate ◽  
The Mean ◽  
Lactate Levels ◽  
One Year

Background : Meningitis is serious and a life-threatening condition among any age group associated with serious mortality and morbidity.  The objective of the present research was to assess the efficiency of CSF lactate in differentiating bacterial/ pyogenic from non-pyogenic meningitis. Subjects and Methods: A hospital-based one-year prospective study was conducted at a tertiary care hospital in Gujarat. The study was performed at the department of General medicine for a period of one year. All the cases suspected of meningitis above 18 years of age irrespective of sex were admitted and clinically evaluated. The Diagnosis of meningitis was made on account of various clinical symptoms   and signs. Like headache, nausea, presence of kernig’s sign, altered sensorium, cranial nerves palsies, hemiparesis, seizures, etc, Results: The mean total cell count was highest in cases of pyogenic meningitis with a mean of 840.50 and SD of 112.30 than viral and tubercular meningitis. However, no statistical significance was associated with total count and types of meningitis. (P> 0.05) Lactate levels of the CSF were elevated than normal in both pyogenic and tubercular than viral, however, the mean CSF lactate was higher in pyogenic than tubercular. A clear statistical significance was observed in CSF sugar/blood glucose ratio and CSF lactate levels in this study (p 0.05). Conclusion: CSF lactate level is a rapid, quite inexpensive and unpretentious process, important diagnostic indicator in the premature demarcation of pyogenic meningitis and tubercular meningitis from viral meningitis, serving in the premature organization of proper action and diminishing transience and impediments. Early detection may help in early decision on the type and institution of appropriate management could reduce the mortality and morbidity of meningitis.

scholarly journals Role of cerebro spinal fluid lactate as a diagnostic marker for differentiation from bacterial and aseptic meningitis

2020 ◽  
Vol 7 (6) ◽  
pp. 887
Author(s):  
Chintha Venkata Subrahmanyam ◽  
Mahesh Vidavaluru
Keyword(s):  
Viral Meningitis ◽  
Common Symptom ◽  
Age Group ◽  
Pyogenic Meningitis ◽  
Tubercular Meningitis ◽  
Mortality And Morbidity ◽  
Csf Analysis ◽  
Threatening Condition ◽  
Csf Lactate ◽  
Early Decision

Background: Meningitis is serious and a life threatening condition among any age group associated with serious mortality and morbidity. CSF lactate may be a good marker to differentiate bacterial from other cause of meningitis. Objective of this study is to evaluate the efficiency of CSF lactate in differentiating bacterial/ pyogenic from non pyogenic meningitis.Methods: A one year prospective study with all cases diagnosed as meningitis was enrolled and CSF analysis was done. Patients were grouped as bacteria, viral and tubercular meningitis based on clinical and CSF analysis. All cytological, biochemical and CSF lactate were estimated and compared with lactate to differentiate pyogenic from non pyogenic meningitis. Statistical analysis was done using SPSS (Statistical Package for Social Sciences) version 20.Results: A total of 120 cases with 74 males and 46 females, majority in 31-50 years age group were included. 59 pyogenic, 37 tubercular and 24 viral meningitis cases were diagnosed. Fever was common symptom (91.67%). Mean CSF protein was highest in pyogenic meningitis (271.1±142.28), 26 cases of tubercular meningitis demonstrated elevated levels of CSF lactate with a cut-off value of >2.1mmol/l (70.27%), five cases of viral meningitis (13.51%) and all 59 cases of pyogenic meningitis (100%).Conclusions: This present study concludes that CSF lactate could be a reliable and valid marker in early differentiation of pyogenic from cases of nonpyogenic meningitis. Early detection may help in early decision on the type and institution of appropriate management could reduce the mortality and morbidity of meningitis.

Troponin T in Hip Fracture Patients: Prognostic Significance for Mortality at One Year

2011 ◽  
Vol 21 (6) ◽  
pp. 757-761 ◽  
Author(s):  
Edward Spurrier ◽  
David Wordsworth ◽  
Steven Martin ◽  
Rory Norris ◽  
Martyn J. Parker
Keyword(s):  
Hip Fracture ◽  
Troponin T ◽  
Prognostic Significance ◽  
The Elderly ◽  
Cardiac Complications ◽  
Mortality And Morbidity ◽  
The Mean ◽  
One Year ◽  
Acute Cardiac Event ◽  
Significant Mortality

Hip fractures are common injuries in the elderly, with significant mortality and morbidity from several factors. Many of these patients have cardiac disease, and some develop cardiac complications which may increase mortality. Troponin T is a marker of myocardial injury but can be raised in other conditions. Patients over 60 years admitted with hip fracture during the study period had their troponin T measured on admission and postoperatively. Assay was performed after the patient had completed their treatment. We report the results of this study one year after the last patient was admitted. 108 patients were recruited. The average age was 84 years, 86% were female. The mean hospital stay was 20 days. This study found that 27% of hip fracture patients had some increase in the troponin T levels in the peri-operative period. This increase was not associated with an increase in early mortality, but there was an increase in one-year mortality for those with an increase in troponin T (45% versus 22%, p=0.03). These findings indicate that the routine measurement of troponin T does not correlate with acute mortality and is not necessary without evidence of an acute cardiac event.

scholarly journals Clinicodemographic Profile of Children with Seizures in a Tertiary Care Hospital: A Cross-Sectional Observational Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Nagendra Chaudhary ◽  
Murli Manohar Gupta ◽  
Sandeep Shrestha ◽  
Santosh Pathak ◽  
Om Prakash Kurmi ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Age Groups ◽  
Idiopathic Epilepsy ◽  
Care Hospital ◽  
Partial Seizures ◽  
Cross Sectional ◽  
Mortality And Morbidity

Seizures are one of the common causes for hospital admissions in children with significant mortality and morbidity. This study was conducted to study the prevalence and clinicodemographic profile of children with seizures in a tertiary care hospital of western Nepal. This prospective cross-sectional study conducted over a period of 2 years included all admitted children (2 months–16 years) with seizures. Among 4962 admitted children, seizures were present in 3.4% (n=168) of children, with male preponderance. 138 (82.1%) children had generalized tonic-clonic seizures (GTCS) and 30 (17.9%) children had partial seizures. GTCS were more common than partial seizures in both sexes (male = 82.7%; female = 81.2%) and age groups. There was no statistical significance in the distribution of seizures (GTCS and partial seizures) with sexes (P=0.813) and age groups (P=0.955). Mean ages of children having GTCS and partial seizures were 8.2±4.6 years and 8.2±4.2 years, respectively. Loss of consciousness (55.4%), fever (39.9%), vomiting (35.1%), and headache (16.1%) were common complaints in seizure patients. Significant number of GTCS cases had fever (P=0.041) and neurocysticercosis (n=72; 43%) was the most common etiology in seizure patients. Idiopathic epilepsy (38 (22.6%)), meningoencephalitis (26 (15.5%)), and febrile convulsions (14 (8.33%)) were other leading disorders in children with seizures.

scholarly journals Psychiatric morbidity in epilepsy

2017 ◽  
Vol 5 (10) ◽  
pp. 4267 ◽  
Author(s):  
Prem Singh ◽  
Achyut K. Pandey
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
The Mean ◽  
Antiepileptic Medications ◽  
Generalized Epilepsy ◽  
One Year ◽  
Patients With Epilepsy

Background: Psychiatric morbidity occurs more frequently in patients with epilepsy than in the general population. Routine evaluation and treatment of psychiatric morbidity can be helpful in improving epilepsy care but such data are relatively meagre from developing countries.Methods: The study was conducted in the Epilepsy Clinic of Department of Neurology at a tertiary care hospital over a period of one year.101 patients were included after fulfilling the inclusion criteria. All the patients seeking treatment in the OPD were screened, assessed and then all procedures were fully explained to them. History regarding name, age sex, socio-demographic profile and detailed history regarding seizure disorder was taken from both the patient and the reliable informant. Bengali version of SRQ-24 was used to screen for psychiatric morbidity.Results: One hundred and one patients with epilepsy consisting of 70 men (69.3%) and 31 women (30.7%) were included. Their ages ranged from 15 to 52, the mean age being 26.17 (SD = 7.84). Out of the 101 patients, 65 patients (64.4%) were suffering from partial epilepsies and 36 patients (35.6%) were suffering from generalized epilepsies. 50.49% of the subjects screened positive for psychiatric morbidity. Psychiatric morbidity was higher in unmarried, unemployed males from rural background who were suffering from generalized epilepsy and taking multiple antiepileptic medications. Psychiatric morbidity was statistically significant in people with poor education and those born at home (p<0.05) as compared to well educated, institutionally born persons.Conclusions: 50.49% of the subjects screened positive for psychiatric morbidity.

scholarly journals The effect of farmer nutrition schools on household food production and women's dietary diversity in Bangladesh

2018 ◽  
Vol 9 (2) ◽  
pp. 89-108 ◽  
Author(s):  
Lidan Du ◽  
Timothy Williams ◽  
Aaron Hawkins ◽  
Sarah McClung ◽  
Teemar Fisseha ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Food Production ◽  
Dietary Diversity ◽  
Statistical Significance ◽  
Phase 1 ◽  
Reproductive Age ◽  
Dietary Quality ◽  
Control Group ◽  
The Mean ◽  
One Year

Introduction: The nutrition situation in Bangladesh has improved substantially over the last decade. Nevertheless, dietary diversity of women of reproductive age continues to be low. In addition, global evidence on the effect of nutrition-sensitive agriculture interventions on dietary diversity is still developing. The Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project implemented a Farmer Nutrition School (FNS) intervention in two divisions (regions) in Bangladesh from 2012 to 2016. FNS targeted pregnant women and mothers with children less than two years of age (PLW) in the lowest two wealth quintiles. FNS was based on three well-established, evidence-based strategies--the essential nutrition and hygiene actions, the homestead food production approach, and farmer field schools. Methods: This study aims to assess the effect of SPRING’s FNS program on women’s dietary diversity, measured by a women’s dietary diversity score (WDDS) based on the nine-item FANTA/FAO scale. We followed up one cohort of women who participated in FNS beginning in November 2014. We undertook a two-stage sampling design to identify these women. First, forty-four FNS groups were randomly selected from the 2,560 FNS that were planned to be implemented during 2014-15. Second, 10 women were randomly drawn from each of the 44 FNS groups, which were scattered across 38 upazilas (sub-districts), 19 each in Barisal and Khulna Divisions. Sample size was calculated to detect a 0.25 effect size in the WDDS with a power of 80% and confidence interval of 95%. Three phases of surveys were conducted: before the FNS began (Phase 1-P1, November 2014), immediately after the completion of the FNS (Phase 2-P2, July - August, 2015), and one year after (Phase 3-P3, July 2016). A total of 386 women completed all three surveys. Data analyses included descriptive statistics and t-tests.  Statistical significance is tested by the adjusted Wald test with a 95% confidence interval. Results: The percentage of FNS participants’ households that produced vegetables, poultry and fish significantly increased between P1 and P2, from 43% to 95% (p<.05), from 75% to 87% (p<.05), and from 48% to 67% (p<.05), respectively. The increases were more or less sustained at P3, at 86%, 92%, and 63%, respectively.  Additionally, the mean numbers of vegetable types grown and of chickens reared increased significantly from P1 to P2 (p<.05) and were sustained at P3, from 1.3 to 4.9 to 4.6, and from 5.3 to 7.9 to 8.4, respectively. The mean WDDS significantly increased from 3.9 to 6.0 between P1 and P2 (p<.05), and was sustained at 5.6 at P3. The proportion of women who reported consuming items promoted in FNS, such as eggs, vitamin-A rich fruits and vegetables, and flesh foods also increased significantly. Conclusions: The FNS approach, which supports agriculture interventions with an explicit nutrition objective, generated rapid and sustained improvement in food production and dietary quality. This study suggests that a program design based on local contexts with moderate management support and minimum material inputs can have a powerful effect on women’s dietary diversity within a short time. Furthermore, with community involvement and ownership in a context like rural Bangladesh, the improvements can be sustained, at least for one year. While this cohort study did not have a built-in control group, the magnitude of the increases in production outcomes and WDDS among FNS participants, coupled with much smaller or no increases at the population level over even longer time periods, suggested that these results were probably largely due to the SPRING FNS intervention.

scholarly journals Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

2016 ◽  
Vol 4 (1) ◽  
pp. 110 ◽  
Author(s):  
Natwar Lal Sharma ◽  
Vasuki Balasubramanyam ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Dengue Fever ◽  
Tertiary Care Hospital ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Case Fatality ◽  
Severe Dengue ◽  
Care Hospital ◽  
Duration Of Stay ◽  
Laboratory Profile ◽  
One Year

Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India.Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted.Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero.Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

scholarly journals Rapid differential diagnostic methods of meningitis in adults

2021 ◽  
Vol 8 (2) ◽  
pp. 260
Author(s):  
Akkamahadevi V. Nipanal ◽  
Nagappa H.
Keyword(s):  
Early Recognition ◽  
Evaluation Study ◽  
Mean Value ◽  
Viral Meningitis ◽  
Diagnostic Methods ◽  
Pyogenic Meningitis ◽  
Exclusion Criteria ◽  
Tubercular Meningitis ◽  
Acute Infections ◽  
The Mean

Background: Acute infections of the nervous system are among the most importantproblems in medicine because early recognition, efficient decision making, and rapid institution of therapy can be lifesaving. Objective of the present study was to find out the usefulness of these two tests, CSF-ADA and CSF-CRP for the rapid diagnosis and differentiation of bacterial, tubercular and viral meningitis in adults.Methods: Fifty meningitis patients were selected after fulfilling the following inclusion and exclusion criteria. A prospective clinical evaluation study is undertaken to study the predictive value of CSF CRP and ADA in relation to various types of meningitis.Results: More than half the cases reported were of tubercular meningitis, followed by viral and pyogenic meningitis. The percentages of tubercular, viral and pyogenic were 52%, 32% and 16% respectively. CRP levels were elevated in pyogenic meningitis; the mean CRP level was 25.26±5.56 mg/dl. ADA activity was found to highest in tubercular meningitis, the mean value was 17.67±8.13 IU/L.Conclusions: Study concluded that combine use of CSF CRP and ADA can be used for early differentiation of bacterial, tubercular, and viral meningitis.

scholarly journals Mortality and morbidity of 118 cases of acute pyogenic meningitis in paediatrics age group

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Bashir Ahmed Kakar ◽  
Sultan Ahmed ◽  
Raz Mohammad Kakar
Keyword(s):  
Age Group ◽  
Fatality Rate ◽  
Pyogenic Meningitis ◽  
Mortality And Morbidity ◽  
Medical College ◽  
High Fatality Rate ◽  
Poor Nutritional Status ◽  
One Year ◽  
Clinical Pictures ◽  
Micro Organisms

One hundred eighteen cases of acute pyogenic meningitis were admitted in the department of paediatrics Liaquat Medical college Hospitals Jamshoro/Hydrabad during one year period with a prevalence of 1.57% of total admissions. Thirty one were neonates and 87 were of post neonatal age group. Gram negative micro-organisms responsible for (66/118) 55.93% of cases with high fatality rate, whereas E.coli was responsible 13/31 (41.93%) in neonates with fatality rate of 58.33% (7/12). In post neonatal period streptococcus pneumoniae responsible for 31/878 cases with fatality rate of 44% ( 11/25 ), and H.influenzae prevalence was 17.24% with fatality rate of 28% (7/25) and Niseria meningitidis was responsible for 28.73% (25/87) cases with fatality rate of 8% (2/25). The overall fatality rate ( mortality + morbidity ) was 31.35% (37/118) various factors responsible for fatality are poor nutritional status, delay in referring the cases and to start of optimal therapy, lack of prompt laboratory aids for identifi cation and sensitivity of micro-organisms, the modified clinical pictures as a result of inadequate treatment before admission.

CERVICAL DISEASES

2016 ◽  
Vol 23 (11) ◽  
pp. 1417-1421
Author(s):  
Mumtu Bai Lakhwani ◽  
Rozina Yasir ◽  
Anila Amjad ◽  
Zain Ali
Keyword(s):  
Vaginal Discharge ◽  
Pap Smear ◽  
False Negative ◽  
Outpatient Clinics ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
The Mean ◽  
One Year ◽  
Cervical Diseases ◽  
Postcoital Bleeding

Objectives: The aim of our study is to compare the efficacies of Pap smearcytology, colposcopy and histopathology, in diagnosis of cervical diseases. Study Design:Cross sectional cohort study. Period: One year from June 2013 to June 2014. Setting:Tertiary care hospital in Karachi, Pakistan. Method: The patient population n=145 consistedof women ranging from age 18 to 80 years old, who had come to the outpatient clinics for avariety of symptoms. Pap smear, colposcopy and histopathology was done for women who hadsymptoms like recurrent vaginal discharge, postcoital bleeding and other diseases of the cervix.Findings were noted on a proforma and all the patients signed a duly informed consent. Datawas analyzed using SPSS version 23. Results: The mean age was 45 +/- 9 years (between24 – 75 years), the parity was 5 +/- 4, normal colposcopy findings were found in n= 66 women,while abnormal findings were found in n=79 women. In the abnormal colposcopic finding groupn=63 had abnormal histopathology (p<0.001) abnormal histopathology was found in n=11women who had normal colposcopic findings (16.67% false negative), the calculated sensitivityand specificity of colposcopy was determined to be 86% and 79%. For pap smear abnormalitywas found in n= 49 patients, out of which n=29 had abnormal findings on histopathology aswell. And for colposcopy and pap smear out of n= 78 patients who had abnormal colposcopicfindings, abnormal pap smear was found in only n= 28 patients. And out of those who hadnormal colposcopy n= 67, n= 21 had abnormal pap smear (False positivity of 31.34%) similarlyout of those who had normal pap smear n= 96, n= 44 had abnormal histopathology (falsenegativity of 45.83%). The calculated sensitivity and specificity of pap smear was 38.8% and71.8% respectively. Conclusion: We have concluded that there is a strong correlation betweenfindings of colposcopy and histopathological diagnosis, but when it comes to the diagnosismade by pap smear and colposcopy and pap smear and histopathology the correlation is weakand not consistent.

Postpartum hemorrhage: An audit of one year at Tertiary Care Hospital

2020 ◽  
Vol 11 (4) ◽  
pp. 22-26
Keyword(s):  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Care Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
One Year

Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality in developing countries. Objective: To determine the maternal outcome by an audit of one year among the cases of primary postpartum hemorrhage at a tertiary care hospital. Methodology: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, DHQ Teaching Rawalpindi from 1st January 2019 to 31st December 2019. A total of 9122 deliveries were conducted at the hospital. We reviewed the charts of all the patients who fulfilled our inclusion criteria and gathered data on a structured, pre-tested proformas prepared for the purpose. Results: A total of 9122 maternities were reported during the study period with the frequency of PPH 70 (0.77%). Booking status, 25 (35.7%), high parity 18 (25.7%), and uterine atony in 54 (77%) out of 70 PPH patients, were associated with PPH. Medical management of PPH with uterotonic drugs was successful in 23 (30%) of patients. Uterine packing was done in 27 (38%) patients and bleeding was successfully arrested in 24 (90%) of these 27 patients. Hysterectomy was performed in 9 (12.8%) patients. Maternal death due to PPH was reported in 1 (1.4%) cases. Conclusion: PPH is the leading cause of maternal mortality and morbidity, associated with booking status, parity, and uterine atony. Hospital management should emphasize the predefined protocol to be followed in managing a patient with postpartum hemorrhage.

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