Study of Trauma Profile and its Outcomes at a Tertiary Care Centre: A Cohort Study of 1000 Cases

Introduction: Trauma has been the leading cause of mortality and morbidity. However, there are changes in pattern of trauma and their outcomes with time. Aim: To study the mode and nature of injury and mortality associated with trauma of head, chest and abdomen. Materials and Methods: A prospective cohort study was conducted on 1000 individuals that presented to emergency surgery ward from 2014 to 2019. Patients presented to emergency surgery of Government Medical College, Amritsar, Punjab, India were observed for various characteristics i.e., age group, mode of injury, site of injury, outcomes and management. Results: The mean age of patients was 33.91±16.29 years with significant male predominance (n=794, 79.4%) (p-value 0.00001). Road Traffic Injuries (RTIs) were the most common mode of trauma affecting 490 patients (49%). Head injury was the most common of all injuries (n=834). Overall mortality was 3.6% (n=36). Mortality was higher in males (p-value 0.00933) and mortality rate of 25% was seen in age group of 61-70 years. Conclusion: RTIs followed by assaults are the most common cause of trauma and it significantly affects young male population. However, mortality rate increases with increase in age group with higher rates in older age groups.

Download Full-text

Transition to oral antibiotic therapy for pyelonephritis in children under 60 days of age: An observational retrospective cohort study

Paediatrics & Child Health ◽

10.1093/pch/pxz164 ◽

2020 ◽

Author(s):

David-Alexandre Lessard ◽

Thelma Huard-Girard ◽

Arnaud Tremblay ◽

Jean-Francois Turcotte

Keyword(s):

Cohort Study ◽

Antibiotic Therapy ◽

Tertiary Care ◽

P Value ◽

Oral Antibiotic ◽

Tertiary Care Centre ◽

Oral Antibiotic Therapy ◽

Observational Cohort ◽

Systemic Symptoms ◽

Retrospective Observational Cohort Study

Abstract Objectives To describe the use of antibiotics and assess if an early transition from intravenous to oral antibiotic therapy is generally safe in infants less than 60 days of age with a diagnosis of pyelonephritis. Methods This retrospective observational cohort study included hospitalized infants less than 60 days with a diagnosis of pyelonephritis based on fever or systemic symptoms and a positive urine culture between January 1, 2015 and July 30, 2017 at a Canadian paediatric tertiary care centre. Results A total of 108 infants were included. Forty-eight of them were under 1 month of age. The median intravenous (IV) antibiotic therapy duration was 3.5 days, with a longer duration of 4 days in infants less than 1 month of age. The total antibiotic therapy was almost equally divided between a shorter (10 days) and longer (14 days) duration. The recurrence of pyelonephritis within the 2 months following the initial urinary infection was 9 % in the group with IV antibiotic therapy duration of <4 days, compared to 11% in the group treated ≥4 days IV (P-value 0.75). There was a recurrence of pyelonephritis of 10.2% in the group treated for 10 days, compared to 11.5% of recurrence in the group treated for 14 days (P-value 1.0). Conclusions Our study provides limited retrospective data regarding the management of pyelonephritis in infants less than 60 days of age. Prospective research is needed to confirm those findings.

Download Full-text

Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194997 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4227

Author(s):

Atul V. Rajkondawar ◽

Amit Yele

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Elderly Patients ◽

Tertiary Care ◽

P Value ◽

Age Group ◽

Elderly Age ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Significant Difference

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.

Download Full-text

Epidemiology of fractures in indoor patients at a tertiary care centre in India: a study of 3000 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214958 ◽

2021 ◽

Vol 8 (1) ◽

pp. 39

Author(s):

Mohan M. Desai ◽

Deven R. Kuruwa ◽

Easwar Elango ◽

Roshan Wade

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Age Groups ◽

Control Measures ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Treatment Protocols ◽

Female Ratio ◽

Femur Fractures

Background: Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.Methods: Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.Results: 43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.Conclusions: Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.

Download Full-text

Randomized trial for fungal corneal ulcer- A comparison of outcome between two regimes of medical treatment with topical natamycin and topical voriconazole in a tertiary care Centre

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2021.059 ◽

2021 ◽

Vol 11 (2) ◽

pp. 289-296

Author(s):

Piyali Sarkar ◽

Kumaresh Chandra Sarkar ◽

Tridib Ranjan Naskar ◽

Shashwat Bhattacharyya ◽

Mukul Chandra Biswas

Keyword(s):

Vision Loss ◽

Tertiary Care ◽

Significant Risk ◽

Effective Control ◽

P Value ◽

Rapid Progression ◽

Tertiary Care Centre ◽

Male Predominance ◽

Group A ◽

Group B

Inflammation of the cornea is known as keratitis. Microbial keratitis is a great challenge for the physicians due to its varied presentation, overlapping symptoms and rapid progression. Though bacterial keratitis is the most prevalent in developing countries but recent increasing trend of fungal keratitis carries a significant risk factors and one of the leading causes of vision loss. Early diagnosis and treatment are the cornerstone for its effective control. Purpose: To determine the outcome and efficacy of treatment with topical natamycin and topical voriconazole in different groups. It was a randomised, prospective, comparative, experimental study. The study populations were selected according to inclusion and exclusion criteria after proper evaluation. The study populations were divided into Group A (treated with 1% topical natamycin) and group B (treated 5% topical voriconazole. The patients were followed up subsequently. Data were collected, tabulated in Excel sheet and analyzed in percentage, proportion, t-test and chi square (χ2) test. The statistically significant was considered if p value <0.05. The average age of the study populations was 39.32 ± 14.99 years. Topical voriconazole was found better against primary fungal ulcer than natamycin but not statistically significant (χ2=0.283, p=0.59). The mean healing times of group A and group B were 25.42 ± 4.59 and 24.92 ± 3.99 days respectively. This study concluded that it had male predominance, commonly involved younger people and poor socioeconomic agricultural workers. Both drugs were found effective against primary ulcer but voriconazole was slightly better.

Download Full-text

Clinical aspects of palmoplantar dermatoses in patients attending tertiary health care centre

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20201585 ◽

2020 ◽

Vol 6 (3) ◽

pp. 383

Author(s):

Yashodha Hassan Vasanthkumar ◽

Mangala Hedne Chandrasekhar ◽

Shamnur Basavrajappa Murugesh

Keyword(s):

Clinical Symptoms ◽

Early Recognition ◽

Tertiary Care ◽

Clinical Aspects ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Health Care Centre ◽

Cross Sectional ◽

Male Predominance

Background: Dermatoses affecting palms and soles are among the most difficult of all dermatological therapeutic problems. Apart from diagnostic difficulties, few palmoplantar dermatoses cause great discomfort and disability and may also affect a person's livelihood. To evaluate demographic aspects like age and gender wise distribution and clinical profile of patients suffering from palmoplantar dermatoses.Methods: This cross-sectional study was conducted between August 2018 to July 2019 in the Department of Dermatology, venereology and leprosy in tertiary care centre. Total 200 cases attending the department of dermatology primarily with complaints pertaining to palms and soles with or without body part involvement in patients of age group between 5-70 yrs. and both sexes were enrolled in the study. Investigations such as direct microscopic examination of scrapings, wet mount with potassium hydroxide, Wood’s lamp examination, patch testing and sample for biopsy was taken. After taking consent a detailed history and clinical examination pertaining to the aim of the study was recorded and analysed.Results: A total of 200 patients were enrolled, among which 63% were males and 37% were females showing male predominance. The most common age group affected was 21-40 years. The most common chief complaint was itching (41.5%). Palmoplantar psoriasis was the most common dermatosis with 23.5% cases.Conclusions: Palmoplantar dermatoses are frequently encountered in the dermatologic field. Early recognition of clinical symptoms and signs aids in diagnostic investigations and helps in appropriate and effective management of illness to improve the quality of life.

Download Full-text

Hydrostatic reducibility of intussusception among different age groups in paediatric population-a descriptive study

International Surgery Journal ◽

10.18203/2349-2902.isj20170223 ◽

2017 ◽

Vol 4 (2) ◽

pp. 732

Author(s):

Sreejith Haridas ◽

Vineed S. ◽

K. Sivakumar

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Descriptive Study ◽

Favourable Effect ◽

P Value ◽

Age Group ◽

Tertiary Care Centre ◽

Duration Of Symptoms ◽

Hydrostatic Reduction ◽

Paediatric Age

Background: Intussusception is one of the most frequent causes of bowel obstruction in infants and toddlers. In children, it is often an idiopathic condition and treated non-surgically by radiologic reduction. Primary aim of study was to analyse the outcome of hydrostatic reduction of intussusception across different paediatric age group patients admitted in a medical college hospital.Methods: This is a hospital based descriptive study conducted in tertiary care centre for one year duration in 2014-2015. 90 patients admitted with diagnosis of intussusceptions for hydrostatic reduction were interviewed with the proforma and details were collected. The procedural detail of hydrostatic reduction was also collected. Patients were followed up for a period of 48 hours post successful hydrostatic reduction.Results: Hydrostatic reducibility of intussusception was 63.3% in less than 3 months age group compared to 93.3% each in other two groups. Overall hydrostatic reducibility was of 83.3%, while 16.7% went for laparotomy. First group had 36.7% cases gone for laparotomy. Analysis of each of the study variables was done to find out their association with hydrostatic reducibility. Only duration, bleeding per rectum, lethargy, dehydration, side of lesion and total count were found to have a statistically significant p value. Logistic regression analysis of the above five variables revealed that only the ‘duration of symptoms’ had a statistically significant independent association with hydrostatic reducibility of intussusception ,with a p value of 0.033 and odds ratio 12.477. 5.3% of cases of first group had recurrence within 48 hours of hydrostatic reduction, while 10.7% and 21.4% of cases from second and third group respectively had recurrence within 48 hours of reduction. Overall recurrence of intussusception within 48hours is 13.3%.Conclusions: Hydrostatic reduction of intussusception is more successful in paediatric age group > 3 months compared to < 3 months. Shorter duration of symptoms, especially < 48 hours may have a favourable effect on hydrostatic reducibility of pediatric intussusception. Rate of recurrence of intussusception within 48 hours of successful hydrostatic reduction is 13.3 per 100 paediatric cases.

Download Full-text

Patterns and Severity of Injuries in Patients Following Road Traffic Accidents – A Medicolegal Aspects

Eastern Green Neurosurgery ◽

10.3126/egn.v2i1.27455 ◽

2020 ◽

Vol 2 (1) ◽

pp. 13-17

Author(s):

Archana Chaudhary ◽

Harihar Wasti

Keyword(s):

Traffic Accidents ◽

Analytical Study ◽

Road Traffic ◽

Tertiary Care ◽

Fracture Dislocation ◽

Common Finding ◽

Age Group ◽

Road Traffic Accidents ◽

Tertiary Care Centre ◽

Life Threatening

Background and purpose: Road traffic accident (RTA) is the major cause of the morbidity and mortality throughout the world and the incidence is still very high in developed and developing countries. With the objective to see the pattern and severity of the injury following RTA from the medico legal point of view, this study was design in a tertiary care centre at far eastern part of Nepal. Material and method: This is a prospective analytical study with non- probability consecutive sampling of road traffic accidents cases presented in the emergency department during period of 6 months. Type of study: Prospective Analytical study. Result: There were total 210 cases of road traffic accidents with mean age of 31.8 (SD 15.7) years where majority were at 20-29 years of age group and males were the majority. Majority of the cases had injuries to the extremities followed by head. Grievous injury and life threatening injuries were also a common finding in this study. Conclusion: Road traffic accidents are more common among male, bike/scooter rider and 22-29 years of age group. Majority of the injury were fracture/dislocation of extremities and intracranial injuries. As per the medicolegal aspect, grievous and life threatening injuries were common findings among patients with road traffic accidents.

Download Full-text

CLINICAL PROFILE AND OUTCOME OF PATIENTS PRESENTING WITH ACUTE UPPER GI BLEEDING IN A TERTIARY CARE CENTRE OF WESTERN NEPAL

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v6i1.21656 ◽

2018 ◽

Vol 6 (1) ◽

pp. 3-7

Author(s):

Shatdal Chaudhary ◽

Smriti Shakya ◽

Niraj Kumar Jaiswal ◽

Aakash Shahi ◽

Pushpa Raj Dhakal ◽

...

Keyword(s):

Peptic Ulcer ◽

Mortality Rate ◽

Peptic Ulcer Disease ◽

Esophageal Varices ◽

Tertiary Care ◽

Age Group ◽

Care Centre ◽

Inclusion Criteria ◽

Tertiary Care Centre ◽

Ulcer Disease

Introduction: Acute upper gastrointestinal (UGI) bleeding is a common medical emergency which is associated with significant morbidity and mortality. The annual incidence of UGI bleeding varies from 48 to 160 cases per 100,000 populations in the United States of America (USA), with a mortality rate of 7% to 10%. The aetiology and outcome of UGI bleeding varies significantly in different geographic regions depending on the demographic and socioeconomic characteristics of the local population. This study was done to evaluate the clinical profile and outcome of patients presenting with acute UGI bleeding at a tertiary care centre in Lumbini zone of Nepal.Material and Methods: This was a hospital based prospective observational study. All the patients who presented with acute UGI bleeding and fulfilled the inclusion criteria from 1st August 2013 to 31st July 2014 were included in the study. The study was cleared by the ethical review committee of the institute and written informed consent was taken from all the patients.Results: During the study period, 70 patients fulfilled the inclusion criteria and were subjected to statistical analysis. The mean age of patients in the present study was 55.11 ± 19.93 years. The majority of patients (30, 43%) were elder, belonging to the age group of more than 60 years. There were 55 (79%) male and 15 (21 %) female. The patients were mostly farmers by occupation accounting 29 (41 %) cases. Ethnically, 26 (3 7%) patients of UGI bleeding were from janajati group where majority of them had esophageal varices. Overall, the peptic ulcer disease was the leading cause of UGI bleeding seen in 26 (37%) patients followed by esophageal varices seen in 23 (33%) patients. 0 positive was the commonest blood group which was found in 28 (40%) of our patients. In our study 44 (63%) patients were alcohol consumers and 37 (53%) had coexisting comorbidities that added for the UGI bleeding related complications. During admission, 7 patients expired causing 10% mortality.Conclusion: Acute UGI bleeding was commonly seen in older age group patients with male preponderance. Peptic ulcer disease was the leading cause of the UGI bleeding. The mortality rate was found to be 10%. The mortality also increased with increasing age and patients with pre-existing co morbidities. Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 3-7

Download Full-text

Epidemiological study of road traffic injury victims attending a tertiary care centre in Hyderabad

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20201493 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1699

Author(s):

Qurat Ul Ain Shadan Taj ◽

Karmakonda Anil Kumar

Keyword(s):

Traffic Accidents ◽

Road Traffic ◽

Tertiary Care ◽

Road Traffic Injury ◽

Road User ◽

Age Group ◽

Road Traffic Accidents ◽

Tertiary Care Centre ◽

Traffic Injury ◽

Road Users

Background: Increased vehicular traffic on roads has now begun to cause road traffic accidents. Road traffic injuries will rise to become the fifth leading cause of death by 2030. In India every year road traffic accidents (RTA) accounts for over 1,00,000 deaths, 2 million hospitalization and 7.7 million minor injuries. The objective of the study was to study the socio-demographic profile and the epidemiological factors related to RTA.Methods: It is a cross-sectional, hospital based descriptive study done on all road traffic injury victims admitted at Owaisi hospital attached to deccan college of medical sciences between April 2013 and July 2014. 573 RTA victims were interviewed using a predesigned questionnaire.Results: Majority of the victims were from the age group of 25 to 39 years (38.4%). Majority are males (85.5%). Majority victims had a primary level of education (29.3%), followed by illiterates (20.6%). Majority victims were from upper lower socio-economic class (34.5%) and lower class (30.4%). Majority of the accidents occurred on weekends (57%). Maximum road traffic accidents (45%) occurred during rainy season. Majority of the road user victims were drivers (47%). Motorised two wheelers (43%) were the leading road users among the victims.Conclusions: Majority of the victims being in the productive age group. Public should be sensitized about the raise in road traffic accidents especially in peak hours and weekends. Motorcyclists being the leading road users among victims must be counselled regularly regarding proper road safety measures.

Download Full-text

Modelling of COVID-19 positive cases at tertiary care hospital of Bundelkhand region of Uttar Pradesh using regression models

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20211252 ◽

2021 ◽

Vol 8 (4) ◽

pp. 1899

Author(s):

Suneel Kumar Kaushal ◽

Navin Kumar ◽

Mukesh Yadav ◽

Ashok Kumar Patel

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Uttar Pradesh ◽

Signs And Symptoms ◽

P Value ◽

Care Hospital ◽

Age Group ◽

Human Beings ◽

Male Population ◽

Cubic Model

Background: Corona viruses signify a most important group of viruses mostly affecting human beings. It is a respiratory infection with common signs and symptoms of fever, cough, sore throat, headache, and loss of taste, loss of smell, respiratory symptoms. In India till 31st December 2020, the total number of confirmed cases were 1,02,86,310; with active number of cases were 2,52,699 number of cases recovered were 98,81,732 while number of deaths were 1,49,018. Objective of the study was to find the quadratic and cubic model of COVID-19 positive cases at tertiary care hospital of Bundelkhand region of Uttar Pradesh.Methods: A hospital based study was carried out with confirmed covid-19 cases admitted to Government Medical College Banda, UP. 1486 cases have been taken from the period of 1st April 2020 up to 31st December 2020.Results: In this study maximum cases (30.14%) belongs to the age group of 30-45 years. Male population is more than females in all districts. In this study the cubic model shows the best fit with the highest R-square value. Difference in the proportion in each age group (p value<0.001) and sign and symptoms (p value < 0.001) were statistically significant.Conclusions: The current study focused on presenting trends in the Bundelkhand region, Uttar Pradesh with respect to the outbreak of COVID-19. The spread of COVID-19 cases follow cubic model. We conclude that cases of COVID-19 will decline in the coming days heading towards the reduction in daily number of cases.

Download Full-text