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Author(s):  
Harendra Kumar Gautam ◽  
Shalani Tripathi ◽  
Amrita Srivastava ◽  
Ruchika Verma

<p class="abstract"><strong>Background:</strong> COVID-19, the respiratory disease caused by the new coronavirus. The loss of smell is an atypical symptom and is usually associated with milder form of this disease compared to severe disease. The aim of this study was to compare the severity of disease in patients with and without loss of smell/taste.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study of 100 patients who were COVID RT-PCR positive, carried out in the COVID care center of a tertiary hospital during the period of 6 months from October 2020 to April 2021.</p><p class="abstract"><strong>Results:</strong> 100 cases of RT-PCR positive patients were divided into two groups (50 cases each of patients with and without loss of smell/taste). The mean age was 55-65 years in both the groups. Throat pain/throat irritation and fever were the most common complaints in the patients of both groups, affecting all the 100 (100%) patients. It was followed by cough in 25 (50%) patients and diarrhea in 12 (24%) patients. 2 (4%) patients had breathlessness in group A. While in group B, 50 (100%) patients had cough and breathlessness. The average SpO<sub>2</sub> was &gt;95 in 45 (90%) patients in group A while in group B, &lt;90 in 30 (60%) patient and &gt;95 in 8 (16%) patients. The CT values of HRCT thorax were &lt;8 in 45 (90%) patients in group A while in group B, &gt;15 in 25 (50%) patients.</p><p class="abstract"><strong>Conclusions:</strong> The treatment outcome was 100% patients being discharged in group A without any complication while in group B, 38 (76%) patients were discharged and 12 (24%) patients expired due to various COVID-19 related complications. From this we conclude that, loss of taste and loss of smell are prognostic indicators of mild type of COVID-19.</p>


Author(s):  
Dharmpal Godara ◽  
Vijay Pal Singh Dhayal

Background: The present study highlights the occurrence of Incidental gallbladder carcinoma (IGBC) detected during histopathological examination in cholecystectomy specimens removed for cholelithiasis. Methods- This is a tertiary hospital based cross-sectional study of 500 cholecystectomy specimens removed during cholelithiasis. Relevant hospital records, histopathology slides and reports were reviewed, re-evaluated and studied. Results: 4(0.80%) cases of incidental gall bladder carcinoma (IGBC) were diagnosed from the histopathological evaluation (HPE) of 500 cholecystectomy specimens, constituting 0.80% of gall bladder specimens received during the study period. The age of the patients with IGBC ranged from 51-80 years. More females were affected than males with a M:F ratio of 1:3. Conclusion: Early detection of IGBC by histopathological examination would have a favourable impact on prognosis and management thereby increasing the survival outcome. Keywords: Cholelithiasis, Incidental Gall Bladder Carcinoma


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pengpeng Liu ◽  
Guangyao Li ◽  
Mei Han ◽  
Chao Zhang

Abstract Background The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. Methods A retrospective study of DRPs and pharmacists’ interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist’s intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. Results A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). Conclusions DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy.


Author(s):  
Majid Ali Sarfraz ◽  
Apurva Raina ◽  
Deepjyoti . ◽  
Arti .

<p class="abstract"><strong>Background:</strong> Tuberculosis (TB) of head and neck is a rare form of extrapulmonary TB but still poses a significant clinical and diagnostic challenge. Rare occurrence and unspecific symptoms of extrapulmonary tuberculosis often leads to misdiagnosis. The aim of the study was to evaluate the various otolaryngological manifestations of extrapulmonary TB and make otolaryngologist aware of these manifestations.</p><p class="abstract"><strong>Methods:</strong> This prospective study included 40 cases who presented to us at a tertiary hospital with various symptoms of head and neck TB. Detailed history with ear, nose throat examination was carried out on all patients. Fine needle aspiration cytology (FNAC), histopathology and Acid-fast bacilli (AFB) staining were done to confirm the diagnosis. After confirmation, patients were started on anti-TB therapy and showed good response to the treatment.  </p><p class="abstract"><strong>Results:</strong> The study included 40 cases who presented to us at a tertiary hospital with various symptoms of head and neck tuberculosis. The majority of these cases had cervical lymphadenopathy (55%) followed by deep neck abscess (20%), laryngeal TB (15%), tubercular otitis media (7.5%) and nasal TB (2.5%). Majority of the cases (65%) belonged to lower socio-economic status. 42.5% of cases had family history of pulmonary TB. Six out of 40 subjects had co-existing pulmonary TB.</p><p class="abstract"><strong>Conclusions:</strong> Otorhinolaryngeal TB can involve any site with unspecific symptoms. The most commonly site involved is cervical lymph node presenting as neck swelling. Variable nature of its manifestations makes it necessary to have high degree of clinical suspicion to make early diagnosis.</p>


Author(s):  
Noor Haslina Mohd Noor ◽  
Noor Hafiza Saad ◽  
Mohammad Khan ◽  
Mohd Nazri Hassan ◽  
Marini Ramli ◽  
...  

Blood transfusion is a fundamental and life-saving procedure where the consequence of errors can be fatal. Nurses’ knowledge plays an essential role in ensuring quality and safety in blood transfusion. The objective of this study was to assess blood transfusion-associated knowledge of tertiary hospital nurses on the east coast of Malaysia. This was a cross-sectional study with 200 registered nurses involved in blood transfusion procedures at Hospital Universiti Sains Malaysia. The knowledge of the nurses was evaluated by using the routine blood transfusion knowledge questionnaire based on five parts, and <50%, 50–74%, or ≥75% of the knowledge was considered as poor, moderate, or high, respectively. Based on the scoring system, the overall knowledge of blood transfusion among Malaysian nurses (33.2 ± 8.4 years) was estimated to be 54.9 ± 7.6%. In individual items, the scoring was 81.0%, 45.4%, 49.2%, 63.0%, and 90.0% in knowledge prior to blood transfusion, on pre-transfusion, on post-transfusion, on complications, and on transfusion policy, respectively. The findings of this study indicated that most of the nurses’ overall knowledge of blood transfusion was at a moderate level; therefore, training courses and continuous medical education are warranted to improve knowledge and skills of the nurses to ensure good practices of blood transfusion.


Rhesus incompatibility can pose a problem in pregnancy and cause obstetric failure in a handful of women. The Rhesus factor is a red blood cell surface antigen; and there are many antigen subtypes that make up the Rhesus blood group systems, of which the most commonly involved and most immunogenically associated with Rhesus isoimmunisation is the D antigen. The objective of this study is to determine the prevalence of Rhesus negativity and the foetomaternal outcomes at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. This was a 5-year retrospective study conducted between 1st January, 2016 and 31st December, 2020 at our Obstetric Unit. Data were retrieved, entered into a pre-designed preformed and analyzed using SPSS version 25.0. Results were presented as mean and standard deviation for continuous variables and frequencies or percentages for categorical variables. Of the 4,571 pregnant women, 104 were Rhesus negative, giving a rate of 2.27%. The most common blood group among the women (53.8%) and their partners (84.6%) was the O blood group. Only 2 (1.9%) women were sensitised. Out of the 104 Rhesus negative women, 81 were unsensitised (77.9%) and received anti-D immunoglobulin. Majority of the babies had a good outcome, though 19 (18.2%) of them were admitted into the special care baby unit for various conditions. The incidence of Rhesus negative pregnancy in our study was 2.27%, and 1.9% of the women were sensitised. Prompt administration of anti-D immunoglobulin after sensitising events and post-delivery is key in the prevention of Rhesus isoimmunisation.


Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1127
Author(s):  
Kateřina Bogdanová ◽  
Lenka Doubravská ◽  
Iva Vágnerová ◽  
Kristýna Hricová ◽  
Vendula Pudová ◽  
...  

Broad-spectrum antibiotics administered to patients with severe COVID-19 pneumonia pose a risk of infection caused by Clostridioides difficile. This risk is reduced mainly by strict hygiene measures and early de-escalation of antibiotic therapy. Recently, oral vancomycin prophylaxis (OVP) has also been discussed. This retrospective study aimed to assess the prevalence of C. difficile in critical COVID-19 patients staying in an intensive care unit of a tertiary hospital department of anesthesiology, resuscitation, and intensive care from November 2020 to May 2021 and the rates of vancomycin-resistant enterococci (VRE) after the introduction of OVP and to compare the data with those from controls in the pre-pandemic period (November 2018 to May 2019). During the COVID-19 pandemic, there was a significant increase in toxigenic C. difficile rates to 12.4% of patients, as compared with 1.6% in controls. The peak rates were noted in February 2021 (25% of patients), immediately followed by initiation of OVP, changes to hygiene precautions, and more rapid de-escalation of antibiotic therapy. Subsequently, toxigenic C. difficile detection rates started to fall. There was a nonsignificant increase in VRE detected in non-gastrointestinal tract samples to 8.9% in the COVID-19 group, as compared to 5.3% in the control group. Molecular analysis confirmed mainly clonal spread of VRE.


2021 ◽  
Author(s):  
Veronica Mandich ◽  
Daniel Chiacchiara ◽  
Marcelo Bravo ◽  
Antonio Pilipec ◽  
Santiago Grimaldi ◽  
...  

Abstract Purpose Comparison between patients admitted to the Intensive Care Unit (ICU) with ventilatory support during the first and second wave (Gamma variant) of COVID 19 in a tertiary hospital in the City of Buenos Aires. Method Descriptive, observational, prospective cohort study in ICU of an acute general hospital in Argentina, with patients adult patients COVID-19 admitted consecutively to the ICU. The ICU the main variables of interest: Demographic and laboratory data, history, duration of MV, mortality. Results 44 patients were recruited during the first wave, and 80 in the second. Significant differences were observed in the second wave for age (60, [SD 11]; vs 68 [SD 11]; p <0.01), days with symptoms (9 [SD 5]; vs 4.5 [SD 3]; p <0.01), duration of MV (10 days [SD 7]; vs 16 [SD 13]; p <0.01), Ferritin (1450 mcg / l [SD 547]; vs 941 mcg / l [ SD 593]; p 0.04) and use of antibiotics (97% vs 45% p <0.01). There was no difference in mortality (66% vs 78% p 0.14) but there was in its primary causes; being more frequent hypoxemia associated with sepsis in the second wave (40% vs 3.4% p <0.01) and hypoxemia and multiorgan failure in the first (28% vs 4% p <0.01). Conclusions During the second wave of the pandemic, due to Gamma variant, more patients were admitted to our unit, younger, with a longer evolution time, a shorter time on MV and a greater inflammatory response, with no difference in mortality, although there was a difference in its causes.


2021 ◽  
Vol 24 (5) ◽  
pp. E906-E908
Author(s):  
Siyi He ◽  
Xiaoyan Liu ◽  
Xia Li ◽  
Xiumei Gao ◽  
Yushan Liu ◽  
...  

Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that threatens global health. During the pandemic period of COVID-19, the task for prevention in the general ward of cardiovascular surgery is fairly arduous. The present study intends to summarize our experience with infection control, including ward setting, admission procedures, personnel management, health education, and so on, to provide references for clinical management.


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