scholarly journals Clinical and Biochemical Profile of COVID-19 Patients Admitted in a Tertiary Care Hospital of Kolkata

2021 ◽  
Author(s):  
Avick Nag ◽  
Soumyadeep Ghosh ◽  
Anushree Pal ◽  
Ankan Saha ◽  
Sanjay Kumar Mandal
Keyword(s):  
Prothrombin Time ◽  
Biochemical Parameters ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Care Hospital ◽  
Biochemical Profile ◽  
Group A ◽  
Group B ◽  
D Dimer

Introduction: The disease caused by Coronavirus (COVID-19), is now pandemic all over the world including India. There are different manifestations of the disease from asymptomatic and mild to severe form. Clinical severity varies from country to country. This study was conducted to document different clinical and biochemical profiles in this Tertiary Care Hospital of Kolkata. Aim: The study was done to observe and to compare the clinical and biochemical profile in asymptomatic to mild and moderate to severe symptomatic patients. Materials and Methods: This was an observational study conducted in Medical College, Kolkata, West Bengal, India. The study was conducted from June 2019 to mid-August 2019. Total 573 Real Time Polymerase Chain Reaction (RT PCR) positive COVID patients were included in this study. All patients were examined and investigated with blood parameters. Patients were divided into two groups (Group A-asymptomatic and mild symptoms and Group B moderate and severe symptoms) clinically. Statistical calculators like Statistical Package for Social Sciences (SPSS) and Soccalculator were used and different biochemical parameters were analysed using Chi-square, unpaired T-test to find out significance among these two groups. Results: Among 573 patients, 222 were in group A and 351 were in group B. Fever was the most common presenting feature (69.6%) followed by dry cough and shortness of breath. Other features were malaise/fatigability, diarrhoea and anosmia. Among the co-morbidities hypertension and diabetes were significantly different between the two groups. Among the biochemical parameters Neutrophil-Lymphocyte Ratio (NLR), C-Reactive Protein (CPR), D-dimer, Prothrombin time, Serum Glutamic Oxaloacetic Transaminase (SGOT), Serum Glutamic Pyruvic Transaminase (SGPT) were significantly different between the two groups. Conclusion: In a tertiary care hospital of Kolkata, fever is the most common presentation followed by dry cough and fatigability in COVID patients. Diabetes and hypertension are the common co morbidities. CRP, NLR, D-dimer, prothrombin time, SGOT and SGPT should be monitored to differentiate between mild and severe cases.

scholarly journals Superiority of Spacer/Mask Topical Anesthetic Compared with Conventional Spray and Gargle Method for Fibreoptic Bronchoscopy

1996 ◽  
Vol 3 (3) ◽  
pp. 176-180
Author(s):  
RC Balkissoon ◽  
L Clelland ◽  
L Whitehead ◽  
MT Newhouse
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fibreoptic Bronchoscopy ◽  
Care Hospital ◽  
Topical Anaesthetic ◽  
Vocal Cords ◽  
Group A ◽  
Gag Reflex ◽  
The Mean ◽  
Group B

OBJECTIVE:To compare the safety and efficacy of a new spacer-oral nasal mask device with those of the standard needle nozzle spray method for the delivery of aerosolized lidocaine to the upper airway for pre-bronchoscopic anaesthesia in a tertiary care hospital.DESIGN:Single-blind randomized control trial.SETTING:University affiliated tertiary care hospital, ambulatory care bronchoscopy unit.SUBJECTS:Thirty consecutive consenting patients referred for fibreoptic bronchoscopy for various indications.INTERVENTION:Thirty randomized subjects received 150 mg of topical 1% aerosolized lidocaine via standard long needle nosed applicator (group A) or via a new oral/ nasal mask with spacer device (group B). Bronchoscopists, blinded as to the preprocedure topical anaesthetic method used, gave additional topical lidocaine at their discretion.MEASUREMENTS:The study nurse recorded the total dose of lidocaine (mg), timing of the procedure (s), cough frequency expressed as coughs per minute (c/min), vital signs, time for return of gag reflex and patients' subjective comments.RESULTS:Fifteen patients were randomized to each group. The lidocaine dose required for insertion through the vocal cords (mean ± SD) was 282.6±66.3 mg in group A and 203.3±70.6 mg in group B (PÃ0.005). Total lidocaine dose required for the procedure was 330.6±70.2 mg in group A and 256.6±75 mg in group B (PÃ0.01). The mean time for passage of the bronchoscope from mouth entry to through the vocal cords was 82.7±54.5 s in group A and 110.5±64.4 s in group B (P>0.1). The mean total time for the procedure was 699.7±377.5 s in group A and 697.2±409.1 s in group B (not significant). The mean cough frequency was 8.2±6.1 c/min in group A and 7.0±5.7 c/min in group B (not significant). There were no statistically significant differences in heart rate, in return of gag reflex time or in complication rate between the two groups.CONCLUSIONS:A statistically significant reduction in the dose of lidocaine is required to achieve equivalent topical anaesthetic for bronchoscopy with a new mask and spacer device compared with a more conventional method. Since no other variables related to the procedure showed a significant difference, the new method appears to be superior to the previous method.

scholarly journals Prospective, randomized, open label comparative study of efficacy of atorvastatin versus atorvastatin with vitamin D3 in patients with dyslipidemia attending tertiary care hospital

2021 ◽  
Vol 10 (9) ◽  
pp. 1076
Author(s):  
Motakatla Usha Rani ◽  
Chitra Karuppiah ◽  
Novaladi Kiruthiga ◽  
Vivek Rayavarapu
Keyword(s):  
Vitamin D ◽  
Cardiovascular Diseases ◽  
Lipid Profile ◽  
Vitamin D3 ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Open Label ◽  
Group A ◽  
Group B

Background: Cardiovascular diseases are one of the most important group of diseases causing premature mortality and morbidity. Dyslipidemia is an independent risk factor for cardiovascular diseases and is a disorder of lipoprotein metabolism. Various research studies support role of vitamin D against dyslipidemia. Vitamin D concentration positively correlates with HDL cholesterol and negatively with serum LDL and triglyceride levels. Vitamin D supplementation to Atorvastatin appeared to have increased cholesterol lowering activity more than either substance did alone.Methods: The study was conducted in an outpatient department of general medicine for a duration of 12 weeks in a tertiary care hospital. Total of 100 patients with dyslipidemia were selected based on measurement of lipid profile. Out of 100 patients, 50 patients under group A were treated with atorvastatin 10mg and balance 50 patients under group B treated with atorvastatin and Vitamin D3 1000 IU/day orally. Patients were followed up monthly for 3 months and lipid profile was assessed at baseline and at the end of study. The baseline characteristics were similar in both study groups.Results: On comparing groups at the end of 12 weeks mean LDL, triglycerides and VLDL were significantly reduced in group B than group A with p<0.001. The mean HDL level too increased in group B than group A with p<0.001.Conclusions: Fasting plasma lipid profile improvement was higher in the atorvastatin with vitamin D3 group compared to atorvastatin group.

scholarly journals An assessment of knowledge, attitude and practices (KAP) towards warfarin medication among patients with prosthetic valve in a tertiary care hospital of south India

2018 ◽  
Vol 7 (10) ◽  
pp. 1877
Author(s):  
Gopisankar M. G. ◽  
Surendiran A. ◽  
Hemachandren M.
Keyword(s):  
Valve Replacement ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cardiac Valve ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Cardiac Valve Replacement ◽  
Group B

Background: Warfarin is a drug with narrow therapeutic index. It requires varied adequate doses for achieving target INR so as to prevent episodes of thromboembolism. It is important to properly educate the patient while prescribing this drug to reduce the side effects and maintain perfect anticoagulation status. This study was done to assess the baseline Knowledge, Attitude and Practices (KAP) towards warfarin medication among patients with cardiac valve replacement in a tertiary care hospital of south India to get a baseline data which can recommend implementation of health education programs targeting these patients.Methods: An observational cross-sectional study was approved by Institute Ethics Committee JIPMER, Puducherry. It included patients on treatment with warfarin maintenance therapy for a period of not less than three months following cardiac valve replacement in the months of October 2016 to October 2017. The questionnaire included 39 questions of qualitative and quantitative basis, which was scored for a total of 50 and analysed using SPSS software.Results: About 240 patients were interviewed who attended cardiothoracic vascular surgery outpatient department and taking warfarin for at least 3 months following surgery of valve replacement. Patients were divided into two groups. Group A included patients who achieved target INR and group B are those out of target INR. 15.7 percent (35) had low score, 76.2 (160) had medium score and 15 (7.1) percent had high scores in group A. In group B 22(81.5%) had medium score and 5 (18.5%) had high score. The median score was more among patients with higher education (p=0.01). There was no significant difference between scores between different age groups or profession.Conclusions: Lack of adequate knowledge exists in patients who are followed in CTVS OPD when assessed about the basic nature of their disease and drug use. It has been shown that group B had more score which may be due to more education they may have received owing to non-attainment of target INR. This study acts as a baseline and thus advocates the need of proper patient education for patients taking warfarin which may improve the treatment outcome.

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

scholarly journals Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai: an 11-year retrospective analysis in a tertiary care hospital

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yan-Jun Zheng ◽  
Ting Xie ◽  
Lin Wu ◽  
Xiao-Ying Liu ◽  
Ling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Severe Neutropenia ◽  
Care Hospital ◽  
The Impact

Abstract Background The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. Methods All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. Results Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not. Conclusions The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.

scholarly journals Prevalence and characteristics of venous thromboembolism in severe exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in India

2021 ◽  
Author(s):  
Soibam Pahel Meitei ◽  
Sudheer Tale ◽  
Arjun Kumar Negi ◽  
Ruchi Dua ◽  
Rohit Walia ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Venous Thromboembolism ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Obstructive Pulmonary Disease ◽  
Test Probability ◽  
D Dimer

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dimer above the age adjusted cut-off underwent computerised tomography pulmonary angiography (CTPA).  Results were analysed using SPSS version 23.  Sixteen (10.3%) patients had VTE, 15 (93.75%) of them being cases of isolated PE. Female gender, higher cumulative past exposure to corticosteroid, higher alveolar-arterial gradient, right ventricular dysfunction, and higher mean pulmonary artery pressure were associated with increased risk for VTE. The prevalence of VTE in AECOPD in this study among an Indian population is higher than among other Asians, but lower than among the Blacks, the Caucasians and the Middle-East ethnicities. Since a vast majority of VTE presents as PE without DVT in the setting of AECOPD, the absence of deep vein thrombosis of lower limbs does not rule PE in the setting.

scholarly journals Prevalence and the risk factors for the carriage of beta-haemolytic streptococci among women visiting a tertiary care hospital in South India

2021 ◽  
Vol 8 (4) ◽  
pp. 308-312
Author(s):  
Pendru Raghunath ◽  
LN Rao Sadanand
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Latex Agglutination ◽  
Research Centre ◽  
Care Hospital ◽  
Microbiological Techniques ◽  
History Of ◽  
Group B

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

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