201 research outputs found
Sort by
A Study of Clinical and Etiological Profile of Anaemia in Geriatric Patients in a Tertiary Care Hospital
No full textBackground: Geriatric anemia is a global health problem because of its high prevalence and associated significant morbidity and mortality. Aim: The objectives of this study were to estimate the pattern of anemia in the elderly patients and the underlying etiology of anemia. Subjects and Methods: This was a hospital-based prospective observational study, conducted in patients aged 60 years and above at SSIMS, T. Begur. Anemia is defined as hemoglobin level less than 13 g/dl in men and 12 g/dl in women. Results: Among the 100 older patients with anemia, the mean value of hemoglobin was 8.9 ± 2.3 g/dl. The etiological distribution of anemia was iron deficiency in 25 patients (25%), chronic disease in 22 patients (22%), hematological disorders in 20 (20%), chronic kidney disease in 12 (12%), multifactorial in 8 (8%), vitamin B12 deficiency in 3 (3%), folate deficiency in 1 (1%), and hypothyroidism in 1 patient (1%). No etiology could be found in 8 patients (8%). 57.6% of the iron-deficient patients had upper gastrointestinal lesions and 30.7% had a nutritional cause. Common chronic diseases causing anemia were malignancy (36.6%) and liver disease (29.1%). The myelodysplastic syndrome was the commonest hematological disorder. 53.35% of the patients had normocytic anemia, 40% had microcytic anemia, and 6.6% had macrocytic anemia. Conclusion: In most of the cases, anemia in the elderly had a treatable cause. Thus, a thorough investigation including gastrointestinal endoscopy is warranted. Unexplained progressive or unresponsive anemia requires bone marrow examination. 
The Role of C Reactive Protein in Fever without Focus among Children Aged Between 1 – 3 Years
No full textBackground: The incidence of invasive pneumococcal disease in children has come down because of polysaccharide vaccine. The increased incidence of bacteremia among young children may be due to part of maturational immune deficiency in the production of opsonic Ig Ganti bodies to the polysaccharide antigens present on en capsulated bacteria. Fever is a common present in gsymp to min paediatric out patient practice and in children less 3 years of age. Approximately 20%to30% of the children may have no identifiable cause off ever after history and physical examination. Subjects and Methods: Children in the age group of 1-3 years presenting to the outpatient department were screened for temperature >39°C and who satisfied inclusion criteria were included in the study. Temperatures were recorded either in the axillary or rectal areas. Informed consent was obtained from parents or guardian & clearance of Institutional Ethical Committee Review Board. Blood samples were taken for total WBC count, ANC, ESR and CRP and at the same time samples for blood culture. Blood cultured in various media incubated overnight and colony morphology was read. Results: CRP >6mg/d1 was observed in 25 cases of children who had SBI giving rise to sensitivity of 75.8%, 46 children who did not have SBI have CRP <6mg/d1 giving a specificity of 39.3%. Among 96 cases with CRP more than 6mg/d1 only 25 (26%) cases had SBI giving PPV of 26%. Among 54 cases of CRP <6mg/d1 46(85%) cases did not have SBI giving a NPV of 85.2%. Conclusion: CRP determines more selective strategy for children with SBI for additional diagnostic studies and appropriate antibiotic therapy. 
A Study of MODS in Dengue Fever with Emphasis on Comparison between Survivors & Non-Survivors
No full textBackground: Dengue is the most common mosquito-borne viral disease throughout the world. Dengue could be asymptomatic or it may manifest as non-severe, severe and fatal types. Severe dengue manifests itself in myriad ways. Excessive hospitalization of dengue patients occurs due to the absence of definite early prognostic markers or early predictors of severity/mortality. There are few Indian studies on mortality in severe dengue. The objective of this study was to explore Multi-organ dysfunction syndrome (MODS) in Dengue fever with an emphasis on comparison between survivors & non-survivors. Subjects and Methods: This study was done at JSS Hospital, a tertiary referral teaching hospital of JSSMC, JSSAHER with 80 adult ICU beds. It was a retrospective observational study. Patients with laboratory-confirmed severe dengue infections satisfying inclusion and exclusion criteria and admitted to the ICU between September 2016 and September 2017, including the large outbreak period were considered. The data were collected from inpatient case-records and the analysis was done, retrospectively. Results: A total of 29 patients met all inclusion and exclusion criteria. In our study, out of 29 cases, total number of males were 17 (58.6%), whereas females were 12 (41.4%). Mean age of patients was 43.37 years (SD:14.36). The mortality of severe dengue with MODS admitted to the ICU remains high (55.2%) in this study. In this study, mean age was more in survivors when compared to non survivors; At admission, Creatinine, Lactate & PCV were higher among non survivors; All patients with Hypotension, Both the patients with ARDS, myocarditis & All the 6 patients who had bleeding manifestations expired & prolonged a PTT and PT-INR were found among many non survivors; Other parameters like LFT, Se.Albumin and Comorbidities did not have any impact on mortality. In this study, though both the groups had hypoalbuminemia, Serum Albumin was not statistically significant between survivors & non-survivors while arterial Lactate, creatinine and PCV were significant. Conclusion: The mortality of severe dengue with MODS admitted to the ICU remains high. In this study, surprisingly, mean age was more in survivors when compared to non-survivors; Creatinine, Lactate & PCV were higher among non-survivors. Other parameters like LFT, Se.Albumin and Comorbidities did not have any impact on mortality. Definite early prognostic markers or early predictors of severity/mortality is the need of the day. 
A Study of Clinical and Laboratory Profile of Dengue Fever in a Tertiary Care Teaching Hospital
No full textBackground: The incidence of Dengue has grown dramatically around the world in recent decades. Year after year, the prevalence of the disease is on a rise. This study is designed to study the clinical and laboratory parameters of Dengue patients in a tertiary care teaching hospital. Subjects and Methods: Prospective observational study was undertaken in a tertiary care teaching hospital. This study was carried out for a period of two years between Jan 2017 to December 2018.Seventy-two patients were studied and analyzed. All patients with positive NS1 antigen and positive ELISA test were included in the study. Clinical, hematological and biochemical parameters were noted.Results: Of the 72 patients, majority were females (52.8 %). Fever was the most common symptom followed by other symptoms like head ache, myalgias etc. Conclusion: Dengue is an important cause of mortality and morbidity in our country. Early diagnosis and prompt management can have a positive effect on the outcome of the disease. Proper monitoring of the clinical and biochemical parameters and necessary intervention can bring down the mortality rates associated with this disease. 
Clinical Profile of Patients with Type 2 Diabetes Mellitus at a Tertiary Care Hospital
No full textBackground: Diabetes mellitus is described as a group of metabolic disorders of multiple etiology characterized by chronic hyperglycemia associated with disturbances of carbohydrate, fat and protein metabolism due to absolute or relative deficiency of insulin secretion and/or action. Diabetes mellitus is associated with significant long term sequels, particularly damage or dysfunction of various organs especially kidneys, eyes, nerves, heart and blood vessels. Subjects and Methods: A pre-structured and pre-tested proforma was used to collect the data. Informed consent was taken from all cases and control subjects. Base line data including age and sex, detailed medical history including conventional risk factors, clinical examinations and relevant investigations were included as part of the methodology. Results: The mean serum FBS level among cases was 146.94±54.99 mg % as compared to 86.71±9.71 mg % among controls. There was highly significant difference in serum FBS levels among cases and controls. Conclusion: The mean serum PPBS level among cases was 244.26±96.47 mg % as compared to 111.96±8.85 mg % among controls. There was highly significant difference in serum PPBS levels among cases and controls. 
Relationship between Smokeless Tobacco Dependence and Psychiatric Disorders
No full textBackground: The epidemiology of nicotine dependence indicates how strongly addictive a drug it is that nearly half of those who ever smoked steadily for a month become highly nicotine dependent. It is a psychoactive substance that induces euphoria, reinforces its own use, and leads to nicotine withdrawal syndrome when it is absent. Subjects and Methods: Written informed consent was taken from all the cases and controls prior to the detailed assessment. The personal data was recorded in the socio demographic data. They were administrated Modified Fagerstrom test for nicotine dependence [FTND] and those who were nicotine dependent were then screened for psychiatric morbidity using GHQ – 12 [69] screening questionnaire. Results: Among those with psychiatric diagnosis majority had Major Depressive Disorder [24%], Generalized Anxiety disorder [18%], Mixed Anxiety Depressive disorder [10%] and Alcohol dependence syndrome[14%] as compared to non nicotine dependents. Conclusion: Severity of Anxiety and depression increased with the severity of nicotine dependence among the cases.Coping skills were not significantly different between cases and controls. 
A Hospital Based Cross-sectional Study on Demographic Distribution of Both Symptomatic and Asymptomatic Patients an Art at Westren Region of Rajasthan.
No full textBackground: Over the past two decades with the advent of highly active antiretroviral therapy (HAART), there is a substantial increase in the life span of HIV patients. Morbidity and mortality due to human immunodeficiency virus (HIV) continue to be major problems in developing countries like India. Subjects and Methods: The present study was a cross sectional hospital based study for a period of twelve months from 1st Nov. 2015 to 31st Oct. 2016 at ART center P.B.M. Hospital, Bikaner. 100 HIV+ patients on ART were included in the study by consecutive sampling technique. Results: We found that Maximum number of study participants in age group of 31-40 years in both study (50%) and control (42%) group. Males were higher in study (76%) as well as control (64%) group than females .Among the subjects mostly belonged to lower socioeconomic status followed by Medium and High socioeconomic status. Most of the subjects in study (92%) as well as control (94%) groups were married. Conclusion: We conclude that Males were higher in study (76%) as well as control (64%) group than females .Among the subjects mostly belonged to lower socioeconomic status followed by Medium and High socioeconomic status. 
Clinical Profile of Idiopathic Pulmonary Fibrosis
No full textBackground: The incidence of IPF was estimated at 10.7 cases per 100,000 per year for men and 7.4 cases per 100,000 per year for women in a population-based study from the county of Bernalillo, New Mexico. A study from the United Kingdom reported an overall incidence rate of only 4.6 per 100,000 person-years, but estimated that the incidence of IPF increased by 11% annually between 1991 and 2003. This increase was not felt to be attributable to the aging of the population or increased ascertainment of milder cases. Subjects and Methods: This was an observational prospective study carried out in the Department of Pulmonary Medicine, Medical College. The study included 35 patients diagnosed with IPF during the two year study period. Results: Dyspnea was the most common symptom at presentation, being present in 35 (100 %) of the patients. Cough with or without expectoration was the next most common symptom, being present in 33 (94.2 %) of the patients. Other symptoms were chest pain, fever and weight loss, and joint pains. Conclusion: Clinical prediction models are used in many areas of medicine to provide accurate prognostic information and staging of disease; such a prediction model would be useful in IPF. 
Evaluation of Incidence of Hepatitis C in Health Care Workers
No full textBackground: Hepatitis C virus infection continues to be a major public health problem warranting high priority efforts for control and treatment. Aim: An observational, cross-sectional facility-based study was conducted to measure the prevalence of HCV infection and to identify risk factors associated with HCV infection among health care workers. Subjects and Methods: A total of 109 participants were selected. It conducted through stratified random sampling. For the analysis, Z-test and Fisher’s exact test were used. All participants in this study were tested for HCV marker (Anti-HC). Results: The positive for Anti-HC was found to be 1.8% (2/109), which was found among nurses and paramedics. The results showed association between Anti-HC positivity and blood transfusion, frequency of blood transfusion and exposure to sharp injuries, P values (0.003, 0.0001 and 0.029) respectively. Conclusion: Prevalence rate of Anti-HC was found to be low in HCWs (1.8%). The prevalence rate was found among nurses and medical engineers. Blood transfusion, frequency of blood transfusion and exposures to sharp injuries to be risk factors with Anti-HC positivity. 
A Cross Sectional Study on Correlation of Quantitative C - reactive protein with CD4 Count in Patients of HIV on Art
No full textBackground: Over the past two decades with the advent of highly active antiretroviral therapy (HAART), there is a substantial increase in the life span of HIV patients. Hence, the focus has now shifted to managing long-term complications of HIV infection and improving the quality of life of HIV patients, especially in developed nations. On the other hand, in developing nations, the ever-growing incidence of HIV infection has placed a huge burden on their frail economy, so there is a growing need for simplifying HIV treatment protocols and for having cheaper alternatives for monitoring disease activity. Subjects and Methods: The present study was a cross sectional hospital based study for a period of twelve months from 1st Nov. 2015 to 31st Oct. 2016 at ART center P.B.M. Hospital, Bikaner. 100 HIV+ patients on ART were included in the study by consecutive sampling technique. Out of 100 patients, 50 were symptomatic and included in study group and remaining 50 were asymptomatic and taken as controls. Results: 37 (74%) patients in study group had CRP levels >6 mg/lit (normal level <6 mg/lit). Out of 37, 19 subjects (38% of total) had CRP level >20 mg/lit. While in control group, 44 subjects (88%) had CRP level <6 mg/lit. Only 6 (12%) subjects of control group had CRP level >6mg/lit. None of control subjects had CRP level >20 mg/lit. The CRP levels and CD4 count were negatively correlated in study group and this was observed to be statistically significant (p=0.04) whereas in control group, the CRP levels and CD4 counts were found to be very weakly positively correlated and this correlation was observed to be statistically insignificant. Conclusion: There was statistical significant difference between CRP range and levels in both the groups. Also statistical significant difference between CD4 count range in both the groups. In our study, 38% of the study group patients had CRP >20 mg/l whereas 88% of the control subjects had CRP of <6 mg/l.