scholarly journals Comparative Study of Physiological and Haematological Parameters among Mild and Severe COVID-19 Patients Admitted in Tertiary Care Hospital of Pune District, India

Author(s):  
Suchita Sachin Palve ◽  
Pallavi Sachin Chaudhari

Background: The COVID-19 pandemic has put global health at stake by creating havoc all over the world, due to which the world, as well as health agencies, are experiencing the greatest challenges. This disease is a health emergency due to its high level of infectiousness and the non-availability of any specific treatment [1]. Objectives: To determine and compare the significance of physiological and haematological parameters in the diagnosis of COVID 19 infection and compare the association of physiological and haematological parameters among mild and severe COVID-19 patients. Methodology: The present comparative, observational study was carried out in a designated tertiary care hospital, where admission of COVID19 patients in Pune district, India. Various parameters like age, height, weight, BMI, various physiological variables, haematological parameters, and CRP levels were assessed among 202 Mild and 50 severe COVID 19 diagnosed patients on day one of the hospital's stays. Results: Pearson’s correlation coefficient showed a significant correlation among physiological and haematological variables compared to both groups, especially physiological parameters like SBP and DBP. The results showed that TLC, CRP, NLR, PLR, among COVID 19 patients cans work as important biomarkers to understand the disease prognosis. Conclusion: Study of physiological and haematological parameters and their interrelation will help in understanding the impact of COVID 19 infection on the reactive inflammatory responses and help in understanding the prognosis of the disease among mild and severe patients.

Author(s):  
Suchita Sachin Palve ◽  
Pallavi Sachin Chaudhari ◽  
Deepa Devhare ◽  
Gauri Milind Kulkarni

Background: The COVID-19 pandemic has put global health at stake by creating havoc all over the world, due to which the world, as well as health agencies, are experiencing the greatest challenges of all times. This disease is a health emergency due to its high level of infectiousness and due to the non-availability of any specific treatment. COVID 19 is a health emergency due to its high infectiousness, as currently, there is no treatment available Objectives: To determine the significance of physiological and haematological parameters in the diagnosis of COVID 19 infection and compare these parameters according to comorbid conditions during the disease progression among mild COVID 19 patients. Methodology: This retrospective, observational study was carried out in a designated tertiary care hospital to address COVID19 patients in the Pune district. Various parameters like age, height, weight, BMI, various physiological variables, haematological parameters, and CRP levels were assessed among 202 COVID 19 diagnosed patients on day one and on day 10 of the hospital stay. Results: Out of the total study participants, 112 were male, and 90 were females with an average age of (43.43±15.07) and (51.8±16.35) respectively. Conclusion: Study of physiological and haematological parameters and their interrelation will help in understanding the impact of COVID 19 infection on the reactive inflammatory responses and will help in understanding the prognosis of the disease.


Author(s):  
Yan-Jun Zheng ◽  
Ting Xie ◽  
Lin Wu ◽  
Xiao-Ying Liu ◽  
Ling Zhu ◽  
...  

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.


Author(s):  
OVAIS ULLAH SHIRAZI ◽  
NORNY SYAFINAZ AB RAHMAN ◽  
CHE SURAYA ZIN ◽  
HANNAH MD MAHIR ◽  
SYAMHANIN ADNAN

Objective: To evaluate the impact of antimicrobial stewardship (AMS) on antibiotic prescribing patterns and certain clinical outcomes, the length of stay (LOS) and the re-admission rate (RR) of the patients treated within the medical ward of a tertiary care hospital in Malaysia. Methods: This quasi-experimental study was conducted retrospectively. The prescriptions of the AMS included alert antibiotics (AA) such as cefepime, ceftazidime, colistin (polymyxin E), imipenem-cilastatin, meropenem, piperacillin-tazobactam and vancomycin were reviewed for the period of 24 mo before (May, 2012–April, 2014) and after (May, 2014–April, 2016) the AMS implementation for the patients who were treated within the medical ward of a Malaysian tertiary care hospital. Patterns of antibiotics prescribed were determined descriptively. The impact of the AMS on the length of stay (LOS) and readmission rate (RR) was determined by the interrupted time series (ITS) comparative analysis of the pre-and post-AMS segments segregated by the point of onset (May, 2014) of the AMS program. Data analysis was performed through autoregressive integrated moving average (ARIMA) Winter Additive model and the Games-Howell non-parametric post hoc test by using IBM Statistical Package for Social Sciences version 25.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: A total of 1716 prescriptions of the AA included for the AMS program showed that cefepime (623, 36.3%) and piperacillin-tazobactam (424, 24.7%) were the most prescribed antibiotics from May 2012 to April 2016. A 23.6% drop in the number of the AA prescriptions was observed during the 24-month post-AMS period. The LOS of the patients using any of the AA showed a post-AMS decline by 3.5 d. The patients’ LOS showed an average reduction of 0.12 (95% CI, 0.05–0.19, P=0.001) with the level and slope change of 0.18 (95% CI, 0.04–0.32, P=0.02) and 0.074 (95% CI, 0.02–0.12, P=0.002), respectively. Similarly, the percent RR reduced from 20.0 to 9.85 during the 24-month post-AMS period. The observed post-AMS mean monthly reduction of the RR for the patients using any AA was 0.38 (95% CI, 0.23–0.53, P<0.001) with the level and slope change of 0.33 (95% CI, 0.14–0.51, P=0.02) and 0.37 (95% CI, 0.16–0.58, P=0.001), respectively. Conclusion: The AMS program of a Malaysian tertiary care hospital was a coordinated set of interventions implemented by the AMS team of the hospital that comprised of the infectious diseases (ID) physician, clinical pharmacists and microbiologist. The successful implementation of the AMS program from May, 2014 to April, 2016 within the medical ward resulted in the drop of the number of AA prescriptions that sequentially resulted in the significant (P<0.05) post-AMS reduction of the LOS and the RR.


2020 ◽  
Vol 42 (3) ◽  
pp. 97-101
Author(s):  
Anish Mudvari ◽  
Dipendra Yadav ◽  
Rakesh Ghimire ◽  
Pravin Prasad

Introduction Adverse drug reaction (ADR) is a leading cause of morbidity and mortality around the world. Causality assessment is done to establish relation of drug exposure with undesired clinical events. This study conducted in tertiary care hospital was undertaken to evaluate the patterns of ADR and causality assessment using Naranjo causality algorithm. MethodsData on suspected ADR cases were collected retrospectively from Medicine and Dermatology wards of Tribhuvan University Teaching Hospital, Kathmandu from April 2018 to April 2019. Naranjo causality assessment was performed. Statistical analysis was done using SPSS version 18. ResultsOf 34 suspected ADR, occurrence of ADR was more in females (18) as compared to males (16). Skin and integumentary system was the most common organ affected (35.29%). Pyrazinamide induced hepatitis was found to be the most common suspected ADR. Causality assessment was performed and ADRs were categorized as possible 17 (50%), probable 16 (47.06%) and definite 1 (2.94%). ConclusionThe patients are commonly admitted at the hospital due to suspected ADRs. Pyrazinamide induced hepatitis was the most common suspected ADR.


Author(s):  
Atul Agrawal ◽  
Ankita Agrawal

Background: Human Immunodeficiency Virus (HIV) has become one of the most serious challenges to public health due to its high morbidity, mortality and economic impacts. Good Knowledge, positive attitudes and practices are important aspects of providing nursing care for people living with HIV/AIDS. Aim: This study aimed to assess knowledge, attitudes and practices of nurses working with HIV/AIDS patients. Methods: This study was descriptive, performed on 200 nurses working with HIV/AIDS patients at a tertiary care Hospital, Amroha. Data was collected using pretested, validated, self administered questionnaire consisting of knowledge, attitude and practice based questions related to HIV/Aids and infected patients along with demographic variables of nursing staff under study.  Results: The result of this study showed that majority of nurses (81%) working with HIV/AIDS patients possess adequate level of knowledge. Most of the nurses under study showed high level of empathic attitude toward people living with HIV/AIDS (above 80%) but at the same time high level of avoidance was observed among some nurses. Practice of nurses working with HIV/AIDS patients was found good. Conclusions: There was satisfactory knowledge, positive attitudes and good practice level among nurses under study. Recommendations: Training should focus on Preventive methods and modes of HIV transmission, care and support of all patients no matter what the disease, emphasizing confidentiality as a patient right that should not be ignored and should train nurses and monitor nursing skills. Keywords: Public health, Nurses, HIV, Knowledge, Attitude, Practices


Author(s):  
Venkateswaramurthy N ◽  
Ashli Raj V ◽  
Nisharani SS ◽  
Limna AL ◽  
Chandini S ◽  
...  

Wound infection has always been a major complication of surgery and trauma. The aim of our study was to determine the bacteriology of wound infections and to study the antibiotic susceptibility pattern of the isolates. The study was conducted in tertiary care hospital, Erode. The design of the study was a prospective type. Pus swabs / specimens were collected from hospitalized patients who developed wound infections. Bacterial pathogens were identified by conventional biochemical methods according to standard microbiological techniques. Antimicrobial susceptibility was performed on Muller – Hinton agar by the standard disk diffusion method. The incidence of wound infection was more common in males (63%) than in females (37%). Out of 100 culture positive samples, 61 samples were collected from diabetic ulcer patients, 20 samples were from ulcer patients, and 19 samples were from post operative patients. Of the 100 samples (culture positive), 71% collected samples showed mono-microbial growth, 29% showed two type of microbial growth. The prevalence of S. aureus (62.87%) from different wound infections was found to be high, followed by E.coli (48.65%), Klebsiella (30.21%), Pseudomonas (22.16%). Organisms showed diversity in the sensitivity pattern towards the antibiotics tested. High level of sensitivity was observed to Imipenem, Piperacillin tazobactum and Amikacin. High level of resistance was observed to Cephalosporins and Penicillin derivatives. We concluded that the sensitivity pattern of the antibiotics is not based on the infection site but on the type of organisms. This study gives us an insight to the current state of causative pathogens and their sensitivity to different antibiotics used in tertiary care hospital, Erode. The data of this study may be used to determine trends in antimicrobial susceptibilities and to modify antibiotic policy of the Hospital.


PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0215996 ◽  
Author(s):  
Masahiro Ishikane ◽  
Kayoko Hayakawa ◽  
Satoshi Kutsuna ◽  
Nozomi Takeshita ◽  
Norio Ohmagari

2008 ◽  
Vol 3 (3) ◽  
pp. 147-155 ◽  
Author(s):  
Truls Østbye, MD, PhD ◽  
Thyagi Ponnamperuma, MBBS ◽  
Nayana Fernando, MBBS, MSc ◽  
Vathsala Abeygunawardena, MSc ◽  
W.A.A. Wijayasiri, MBBS, MSc ◽  
...  

Objective: Sri Lanka’s human, physical, social, and economic resources suffered a massive impact after the tsunami of December 26, 2004. To assist in preparing for future disasters, the authors sought to characterize the pattern of hospitalizations from the main impact zone in the Southern Province.Design: Retrospective chart review.Setting: Patients admitted to Teaching Hospital, Karapitiya, the only tertiary care hospital in the Southern Province.Patients, Participants: All hospital admissions on the day of and week following the tsunami, and a random sample (5 percent) of admissions from the month preceding, and the 3 months following the tsunami were coded according to the International Classification of Diseases, 10th Edition, analyzed, and geomapped.Intervention: N/A.Main Outcome Measure(s): The overall daily number of hospitalizations increased by 50 percent on the day of the tsunami and decreased in the following week.Results: Before the tsunami, injuries typically accounted for 20 percent of hospital admissions. However, injuries were markedly higher (89 percent of the total) on the day of the tsunami and remained elevated (35 percent) during the following week. After the initial peak in injuries (including near drownings), there was no increase in the frequency of infectious, cardiac, or psychiatric admissions.Conclusions: Injuries (including near drownings) were the most common cause of admissions immediately after the tsunami.The distribution of specific diagnoses differed from that seen after other natural disasters such as earthquakes and hurricanes. A central aspect of disaster relief operations and planning includes a thorough understanding of the postdisaster health effects and changes in disease patterns.


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