scholarly journals Kawasaki disease: Clinico-laboratory spectrum and outcome in a cohort of children treated at a tertiary care hospital in Islamabad, Pakistan

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Seema Sakina ◽  
Syeda Sobya Owais ◽  
Ejaz Ahmed Khan ◽  
Abdul Malik Sheikh
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Dose ◽  
Care Hospital ◽  
Incomplete Kawasaki Disease ◽  
Laboratory Spectrum

Objective: To describe the demographics; clinical, laboratory, echocardiographic findings; treatment and outcome in a cohort of children with Kawasaki disease in a tertiary care hospital. Methods: This is a descriptive, observational, retrospective cohort study conducted at Shifa International Hospital, Islamabad, from January 2013-June 2019. Children who met the criteria for Kawasaki disease according to the American Heart Association and American Academy of Pediatrics guidelines were included. Results: A total of 25 children who met the criteria of Kawasaki disease were included. Their mean age was 43 months (4-150 months). Majority (76%) were males. Eighteen (72%) had complete Kawasaki disease and 7 (28%) had incomplete Kawasaki disease. Fever (> five days) was present in 20 (80%) patients. Eight patients (32%) had echocardiographic changes, out of which two patients (25%) had complete Kawasaki disease and six patients (75%) had incomplete Kawasaki disease. Intravenous immunoglobulin was given to all patients. Fifteen children (60%) received intravenous immunoglobulin within 10 days of fever. None required a second dose. All patients received high dose aspirin at diagnosis which was reduced to antiplatelet dose after resolution of fever for ≥48hrs. Eighteen patients (72%) came for regular follow up. Follow up at 6 months showed complete resolution of echocardiographic changes in six patients (75%), 1 (12.5%) was lost to follow up and one (12.5%) child had persistent coronary artery dilatation. Conclusion: Complete KD was present in 72% of our cohort of children. Coronary artery abnormalities were present in one third of these children, at younger age and more common in those with incomplete KD but recovered in most. doi: https://doi.org/10.12669/pjms.36.2.910 How to cite this:Sakina S, Owais SS, Khan EA, Sheikh AM. Kawasaki disease: Clinico-laboratory spectrum & outcome in a cohort of children treated at a tertiary care hospital in Islamabad, Pakistan. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.910 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Chemo-prophylaxis of COVID-19 with hydroxychloroquine: a study of health care workers attitude, adherence to regime and toxicities/side effects (Preprint)

2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  
Keyword(s):  
Side Effects ◽  
Health Care Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perceived Threat ◽  
Care Hospital ◽  
Care Workers ◽  
Perceived Danger ◽  
Structured Questionnaire

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.

scholarly journals PITYRIASIS ROSEA MIMICKING POLYMORPHIC ERUPTIONS OF PREGNANCY

2017 ◽  
Vol 10 (10) ◽  
pp. 21
Author(s):  
Balaji Ommurugan ◽  
Amita Priya ◽  
Swaminathan Tambaram Natesh
Keyword(s):  
Pregnancy Outcomes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Unknown Etiology ◽  
Care Hospital ◽  
Pityriasis Rosea ◽  
Human Herpes Virus

ABSTRACTPityriasis Rosea is a self-limiting skin disorder of unknown etiology affecting women more than men. It is very rare in pregnancy and evidence shows conflicting reports on pregnancy outcomes related to Pityriasis Rosea. But however recent evidence says, pregnancy outcomes are not altered, although clinicians must monitor the patient throughout the gestation for adverse outcomes. Hence, we report a case of Pityriasis Rosea infection in a primigravida, in the first trimester and the follow up done in a tertiary care hospital in Southern India.KEYWORDSRASH, FIRST TRIMESTER, ANOMALY SCAN, HUMAN HERPES VIRUS

scholarly journals Incidence of appendicitis and ovarian cyst among female patients presenting with acute abdomen at a tertiary care hospital

2018 ◽  
Vol 6 (12) ◽  
pp. 3838
Author(s):  
E. Chandrasekhara Reddy ◽  
Janaki Vellanki
Keyword(s):  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Renal Colic ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Time Rate ◽  
Delayed Wound Healing ◽  
Female Patients

Background: Physicians working in casualty are often confronted with acute abdomen and get much more bothered as the diagnosis is not easy. This is due to the fact that the etiology of acute abdomen is always much diversified and the classical findings are masked making the diagnosis difficult. Objective was to study incidence of appendicitis and ovarian cyst among female patients presenting with acute abdomen.Methods: A hospital based follow up study was carried out among 64 cases presented with acute abdomen to the casualty from January 2018 to August 2018. All necessary investigations were done to confirm the etiology of acute abdomen. The cases belonged to surgery and gynecology departments where they were operated. The patients were followed from admission in the casualty to the final outcome. The data was analyzed using proportions.Results: During the study period a total of 15413 patients were admitted in the casualty out of them, 64 (0.42%) presented with acute abdomen. Of these 64 cases, majority i.e. 35 (54.7%) were due to acute appendicitis; 13 cases were due to renal colic and eight cases each were due to ectopic pregnancy and ovarian cyst. The most common age group affected was 21-30 years (62.5%) followed by less than 20 years age (21.9%). 25% of the 64 cases had delayed wound healing and no other complications were reported. No death was recorded.Conclusions: Authors achieved excellent results as there were no major complications and no death was recorded. Thus, meticulous diagnosis and prompt treatment can save patient life and at the same time rate of complications can be reduced.

A follow-up study to evaluate psychological impact among patients admitted for COVID-19 treatment to a tertiary care hospital

2021 ◽  
Vol 7 (2) ◽  
pp. 128
Author(s):  
RajKiran Donthu ◽  
AbdulSalaam Mohammed ◽  
SankarReddy Tamanampudi Pratap ◽  
RamyaKrishna Kurma
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychological Impact ◽  
Care Hospital ◽  
Follow Up Study

To Determine the Frequency of Extent of Coronary Artery Disease (CAD) with Troponin-I level >10 folds ULN in NSTEMI Patients at Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 2757-2762
Author(s):  
Vinesh Kumar ◽  
Fawad Ali Siddiqui ◽  
Kiran Irfan ◽  
Muhammad Adeel Qamar ◽  
Ghulam Jaffar Shah ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Troponin I ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Vessel Disease ◽  
The Mean ◽  
Artery Disease ◽  
Single Vessel Disease

Introduction: Higher levels of troponins >10 folds of upper normal limits (UNL) are considered as high-risk patients on coronary angiography sufferers having high levels of troponin-I (>10 folds upper limit normal level) had extra three-vessel coronary artery disease involvement. Objectives: To determine the frequency of degree of cardiovascular disease with Troponin-I level >10 folds ULN in NSTEMI patients at tertiary care hospital. Methodology: It is a cross-sectional study comprising of a total 800 patients recruited from the Department of Cardiology, National Institute of Coronary Disease, Karachi Pakistan based on Exclusion/Inclusion criteria. Results: There are 678 male as well as 122 female patients. The mean troponin-I level was 15.00±6.82 ng/ml. Single vessel disease found in 25.25% cases, two vessel diseases were observed in 37.75% cases, and three vessel diseases were observed in 20% cases. 83% were found with extent of CAD findings on angiography. There have been 678 male and also 122 female patients. The mean troponin-I level was 15.00±6.82 ng/ml. Single vessel disease found in 25.25% cases, two vessel diseases were observed in 37.75% cases, and three vessel diseases were observed in 20% cases. 83% were found with extent of CAD findings on angiography. Conclusion: The higher troponin level found significantly associated with extent of CAD and three vessel disease. To understand the cardiovascular troponin condition of the sufferer as soon as feasible is crucial. Keywords: Extent of Coronary Artery Disease, NSTEMI, Troponin-I Level >10 Folds ULN

scholarly journals Chest Pain in Emergency Department Patients: If the Pain is Relieved by Nitroglycerin, is it More Likely to be Cardiac Chest Pain?

CJEM ◽  
2006 ◽  
Vol 8 (03) ◽  
pp. 164-169 ◽  
Author(s):  
Robert Steele ◽  
Timothy McNaughton ◽  
Melissa McConahy ◽  
John Lam
Keyword(s):  
Coronary Artery Disease ◽  
Emergency Department ◽  
Chest Pain ◽  
Coronary Artery ◽  
Diagnostic Test ◽  
Tertiary Care ◽  
Positive Likelihood Ratio ◽  
Care Hospital ◽  
Artery Disease

ABSTRACT Introduction: It is often believed that chest pain relieved by nitroglycerin is indicative of coronary artery disease origin. Objective: To determine if relief of chest pain with nitroglycerin can be used as a diagnostic test to help differentiate cardiac chest pain and non-cardiac chest pain. Design: Prospective observational cohort study with a 4-week follow-up of patients enrolled. Setting: Academic tertiary care hospital, with 60 000 visits/year. Inclusion criteria: Adult patients presenting to the emergency department with active chest pain who received nitroglycerin and were admitted for chest pain. Exclusion criteria: Patients with acute myocardial infarction diagnosed after obtaining an ECG, patients whose chest pain could not be quantified, those for whom no cardiac work-up was done, or those who received emergent cardiac catheterization. Results: 270 patients were enrolled. Nitroglycerin relieved chest pain in 66% of the subjects. The diagnostic sensitivity of nitroglycerin to determine cardiac chest pain was 72% (64%–80%), and the specificity was 37% (34%–41%). The positive likelihood ratio for having coronary artery disease if nitroglycerin relieved chest pain was 1.1 (0.96–1.34). Telephone follow-up at 4 weeks was performed, with a 95% follow-up rate. Conclusions: Relief of chest pain with nitroglycerin is not a reliable diagnostic test and does not distinguish between cardiac and non-cardiac chest pain.

Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

2019 ◽  
Vol 30 (2) ◽  
pp. 163-171
Author(s):  
Amod Tilak ◽  
Smita Shenoy ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Amruta Tripathy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
P Value ◽  
Care Hospital ◽  
Long Term Treatment ◽  
Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

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