A MULTI-DISCIPLINARY COMPREHENSIVE GERIATRIC ASSESSMENT OF ELDERLY SUBJECTS IN A SUPERSPECIALITY TERTIARY CARE HOSPITAL, DELHI.

2021 ◽  
pp. 15-18
Author(s):  
Namit Mathur ◽  
Neha Mathur ◽  
Vinod Kumar ◽  
Vikrant Negi
Keyword(s):  
Elderly People ◽  
Geriatric Assessment ◽  
Environmental Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Underlying Disease ◽  
Elderly Subjects ◽  
Care Hospital ◽  
Health And Social Care

Introduction: The comprehensive assessment of elderly people who requires health and social care is becoming of increasing importance. The study was conducted to detect various morbidities in elderly people based on their physical, psychological, and socio-environmental assessment. Material & Methods: history of any underlying disease of each subject was obtained. General physical examination and wherever required, relevant laboratory investigations were performed, followed by comprehensive geriatric assessment (CGA) which consisted of three components namely physical, psychological and socio environmental assessment. Results: Among 150 subjects, 37% had suspected respiratory, 33% musculo-skeletal and 27% gastrointestinal system diseases. Symptoms were less prevalent among those subjects who had regular health checkups. Depression was noted in 43% and impaired memory in 12%. Socio environment impairments that were present were unsafe homes (13%), absence of social support (6%) and lonely living (7%). Conclusion: The family physician should always perform careful CGA along with required laboratory diagnosis which can help in proper rehabilitation of the patient and unnecessary sufferings can be avoided.

SEROPREVALENCE OF HIV AND HBsAg AMONGST BLOOD DONORS IN A TERTIARY CARE HOSPITAL, CHHATTISGARH.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Anusha P ◽  
Bankar Nandkishor J ◽  
Karan Jain ◽  
Ramdas Brahmane ◽  
Dhrubha Hari Chandi
Keyword(s):  
Hepatitis B ◽  
Blood Donors ◽  
Hepatitis B Surface Antigen ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Blood Bank ◽  
Care Hospital ◽  
Medical College ◽  
The World ◽  
First Time

INTRODUCTION: India being the second highly populated nation in the world. HIV/AIDS has acquired pandemic proportion in the world. Estimate by WHO for current infection rate in Asia. India has the third largest HIV epidemic in the world. HIV prevalence in the age group 15-49 yrs was an estimate of 0.2%. India has been classified as an intermediate in the Hepatitis B Virus (HBV) endemic (HBsAg carriage 2-7%) zone with the second largest global pool of chronic HBV infections. Safety assessment of the blood supply, the quality of screening measures and the risk of transfusion transmitted infectious diseases (TTIs) in any country can be estimated by scrutinizing the files of blood donors. After the introduction of the blood banks and improved storage facilities, it became more extensively used. Blood is one of the major sources of TTIs like hepatitis B, hepatitis C, HIV, syphilis, and many other blood borne diseases. Disclosure of these threats brought a dramatic change in attitude of physicians and patients about blood transfusion. The objective of this study is to determine the seroprevalence of transfusion transmitted infections amidst voluntary blood donors at a rural tertiary healthcare teaching hospital in Chhattisgarh. MATERIAL AND METHODS: This retrospective study was carried out in Chandulal Chandrakar Memorial Medical College, Kachandur, Durg. Blood donors were volunteers, or and commercial donors who donated the blood and paid by patients, their families, or friends to replace blood used or expected to be used for patients from the blood bank of the hospital. After proper donation of blood routine screening of blood was carried out according to standard protocol. Laboratory diagnosis of HIV 1 and HIV 2 was carried out by ELISA test. Hepatitis B surface antigen was screened by using ELISA. RESULTS: A total of 1915 consecutive blood donors’ sera were screened at Chandulal Chandrakar Memorial Medical College, blood bank during study period. Of these 1914 were male and 1 female. The mean age of patients was found to be 29.34 years with standard deviation (SD) of 11.65 Years. Among all blood donors in present study, 759(39.63%) were first time donors and 1156(60.37%) were repeated donors. 1 patient was HIV positive in first donation group while 3 (75%) were positive in repeat donation group. 7 (38.9%) were HBsAg positive in in first donation group while 11(61.1%) were positive in repeat donation group. Two patients in first donation group had dual infection of HIV and HBsAg. CONCLUSION: Seropositivity was high in repeated donors as compared to first time donors. The incidence of HIV is observed to be 0.2% and that of HBsAg is 0.94%. Strict selection of blood donors should be done to avoid transfusion-transmissible infections during the window period.

scholarly journals KNOWLEDGE REGARDING HIV/AIDS AND MOTHER TO CHILD TRANSMISSION ISSUES AMONG WOMEN SEEKING ANTENATAL CARE IN VIMSAR, BURLA

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Shilpa Karir ◽  
Dr. Smita Kumari Panda ◽  
Dr. Sadhu Charan Panda
Keyword(s):  
Antenatal Care ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Care Hospital ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cross Sectional ◽  
Keywords Hiv ◽  
Mother To Child ◽  
Hiv Aids

Globally, around 34 million people are living with HIV in 2010, and 35% of the pregnant women are tested for HIV in the low and middle income countries. HIV infection in pregnancy has become a complication of pregnancy in some developing countries. This has major implications for the management of pregnancy and birth. A cross sectional study was conducted from December 2018 – February 2019 in tertiary care hospital, VIMSAR Burla . The present study was conducted to assess the knowledge about HIV/AIDS and mother to child transmission issues among women seeking antenatal care and visiting ICTC. A sample of 150 pregnant females was used to accomplish the study. A pre- tested semi-structured questionnaire was used to gather information on the study variables. The questionnaire included variables related socio-demographics e.g., age, education status, occupation, residence, awareness about HIV/AIDS. The study reflected that 83.4% of the women had heard of the term HIV/AIDS which reflects a relatively high level of awareness about the term but subsequently dropping levels of awareness about the routes of transmission, laboratory diagnosis and the availability of drugs. Only 45.3% of the respondents were aware of ICTC. 42.7% were aware about mother to child transmission of HIV and only 32% were aware of anti-retro viral therapy for newborn. Keywords: HIV, ICTC, Antenatal

scholarly journals P0806RESIDUAL RENAL FUNCTION IS COMPLEMENTARY TO GERIATRIC ASSESSMENT SCORE IN ASSESSING CLINICAL RISK OF ELDERLY PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alberto Castagna ◽  
Davide Bolignano ◽  
Irma Figlia ◽  
Rosa Paola Cerra ◽  
Carmen Ruberto ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Stratification ◽  
Activities Of Daily Living ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
The Elderly ◽  
Residual Renal Function ◽  
Elderly Subjects ◽  
Old Patients

Abstract Background and Aims Renal function impairment is highly pervasive in the elderly and triggers increased morbidity and mortality. Comprehensive geriatric assessment (CGA) is a validated multidisciplinary instrument to assess medical, psychosocial and functional limitations of old patients with diagnostic and risk-stratification purposes. In a focused cohort of frail individuals, we aimed at evaluating possible relationships between single CGA items and renal function. Method 254 consecutive elderly subjects (mean age 79.9±6.6 years, female 65.8%) from the geriatric division of a large Italian community hospital were studied. We collected clinical data including CGA and renal function (CKD-EPI formula). CGA single items included the Cumulative Illness Rating Scale (CIRS), the Exton Smith Scale (ESS), the Mini Nutritional Assessment Short Form (MNA-SF), the Katz‘s Activities of Daily Living (ADL), the Lawton’s Instrumental Activities of Daily Living (IADL), the Short Portable Mental Status Questionnaire (SPMSQ) and the amount of drugs administered (AD). Results Mean eGFR was 66.37±30.94 mL/min/1.73 m2. Overall, the reported CIRS, ESS, MNA, ADL and AD scores were low (7.6±3.3) while IADL and SPMQ were on a mild range, denoting a potential alarm signal for poor prognosis and the risk for adverse outcomes. At univariate analyses, eGFR was significantly associated with CIRS (R=-0.389, p<0.0001), ESS (R=0.355, p<0.0001), MNA (R=0.394, p<0.0001), ADL (R=0.394, p<0.0001), AD (R=-0.374, p<0.0001. while a weak, although significant correlation was found with IADL (R=0.131, p=0.038) and SPMSQ (R=-0.141, p=0.038). In a fully adjusted multivariate analyses only SPMSQ (ß=-0.174, p=0.04), ADL (ß=0.182, p=0.012), IADL (ß =0.209, p=0.003) and AD (ß=-0.354, p<0.0001) remained significant predictors of residual renal function. Conclusion In elderly frail subjects, residual renal function may influence daily life and cognitive activities, the perceived quality of living and the entity of drug assumption. Inclusion of renal function within a comprehensive geriatric assessment could help improving risk stratification in the elderly

scholarly journals Clinical and Sero Immunological Profile of Scrub Typhus in Bengaluru, Southern India

2020 ◽  
Author(s):  
JV Shwetha ◽  
Sneha K Chunchanur ◽  
R Ambica
Keyword(s):  
Phylogenetic Analysis ◽  
Scrub Typhus ◽  
Ethylenediaminetetraacetic Acid ◽  
Severe Disease ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Southern India ◽  
Strain Typing ◽  
Care Hospital ◽  
Pcr Rflp

Introduction: Scrub typhus is a common but neglected cause of Acute Febrile Illness (AFI) in India. Under diagnosis of this severe disease with protean manifestations, can negatively influence the treatment and outcome. Early laboratory diagnosis by appropriate means is therefore important. In addition, as antigenically diverse variants of Orientia tsutsugamushi (O.tsutsugamushi)are known to exist and evolve, information regarding the strain types is also crucial. Aim: To know the clinical spectrum, laboratory diagnosis by different modalities, outcome and strain variation of scrub typhus in Southern India. Materials and Methods: A prospective cross-sectional study was conducted in a Tertiary Care Hospital in Bengaluru, Southern India from June 2015 to May 2017. Hundred clinically suspected cases of scrub typhus (rickettsioses) were enrolled. Serum and EDTA (Ethylenediaminetetraacetic acid) blood samples were subjected to serodiagnosis for scrub typhus and Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) respectively. Strain characterisation was done by Microimmunofluorescence (MIF), PCR-RFLP and phylogenetic analysis. Patients were followed-up for four weeks. Data was entered in Microsoft Excel spreadsheet and analysed using Statistical Package for the Social Sciences (SPSS) software. Results: Laboratory evidence of scrub typhus was showed by 38% of the cases. Seropositivity was more in comparison to PCR. Paediatric preponderance and seasonal trend was evident. Strain typing showed presence of different strain types, with no correlation between clinical features and strain types. PCR-RFLP results correlated well with phylogeny, while MIF results did not match. All the patients responded to doxycycline, except for 12% who succumbed. Conclusion: Different strain types of O. tsutsugamushi are known to cause scrub typhus in Southern India. PCR-RFLP can be a useful preliminary tool for strain typing in resource poor settings, where phylogenetic analysis is not possible. Early diagnosis and treatment helps in improved outcome.

scholarly journals Histopathological evaluation of Endometrium hyperplasia and it’s correlation with the clinical parameters in a tertiary care hospital

2021 ◽  
Vol 6 (3) ◽  
pp. 187-190
Author(s):  
Tina Rai ◽  
Upasana Uniya ◽  
Archana Shrivastava ◽  
G.S Rai
Keyword(s):  
Endometrial Hyperplasia ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Underlying Disease ◽  
Uterine Bleeding ◽  
Clinical Parameters ◽  
Care Hospital ◽  
Age Group ◽  
Proper Management

: Abnormal uterine bleeding is a common clinical presentation in the perimenopausal age group its biopsy serves as an excellent clue to the underlying disease. The presentation may vary according to the type of endometrial hyperplasia and their correlation helps in the proper management of the patients complain.: To analyze the histopathological patterns of endometrial hyperplasia as well as to correlate endometrial hyperplasia with the clinical parameters.: It is a retrospective study and included one year data. A total of 125 cases that underwent hysterectomies or endometrial biopsies for abnormal uterine bleeding were recorded with their clinical history. For all cases the histopathology slides were re-evaluated and results were recorded. Epidemiological variables were analyzed by cross tabulation to assess their relationship. Out of 125 cases 53 cases had endometrial hyperplasia, 24 cases were having simple hyperplasia followed by 14 cases with simple hyperplasia without atypia, 9 cases with complex hyperplasia with atypia followed by 6 cases with complex hyperplasia without atypia. 30 to 50 years age group commonly had endometrial hyperplasia & menorrhagia was the common clinical complain in our patients.: In all the females coming to OPD with abnormal uterine bleeding clinical correlation should be properly made with biopsy report of the patient for the proper management of the condition, which avoids landing up of the patient into further complication.

scholarly journals Intentional or unintentional drug poisoning in elderly people: retrospective observational study in a tertiary care hospital in Japan

2019 ◽  
Vol 6 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Takeshi Haoka ◽  
Nobuo Sakata ◽  
Hiroyuki Okamoto ◽  
Akiko Oshiro ◽  
Takafumi Shimizu ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly People ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
Care Hospital ◽  
Drug Poisoning

EFFECTIVENESS OF A COMPREHENSIVE GERIATRIC ASSESSMENT TO IMPROVE THE LIFE QUALITY OF THE ELDERLY AND TO EASE THE CAREGIVERS BURDEN

2021 ◽  
pp. 79-90
Author(s):  
Evgenia A. Gurianova ◽  
Enje E. Rechapova ◽  
Ekaterina S. Sidyakina
Keyword(s):  
Elderly People ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Life Quality ◽  
Modern Society ◽  
The Elderly ◽  
Diagnostic Process ◽  
Modern World ◽  
Rehabilitation Programs

In the modern world, the number of elderly people with various diseases is growing, they need an appropriate care. Care implementation requires special knowledge, mental and economic expenditures. Ensuring a decent old age for the elderly is one of the problems of modern society. Comprehensive geriatric assessment is a multidimensional interdisciplinary diagnostic process for assessing the physical, psychological, functional and socio-economic problems of elderly people in order to develop a comprehensive individual plan for their treatment and rehabilitation. Comprehensive geriatric assessment benefits the elderly population, but the effectiveness of comprehensive geriatric assessment to improve the life quality of the elderly remains unclear. The article provides an overview of studies devoted to studying the effectiveness of using comprehensive geriatric assessment. The article discusses the influence of a comprehensive geriatric assessment on determining the life quality of the elderly, the duration of their stay in the hospital, and relieving the caregivers' burden. In addition, the influence of a comprehensive geriatric assessment on the ability to determine life expectancy, to conduct early diagnosis of major geriatric syndromes, the risk of morbidity and mortality in elderly patients is being considered. It is important that on the basis of a comprehensive geriatric assessment, appropriate rehabilitation programs can be drawn up, and technologies for rehabilitation can be determined.

scholarly journals Comprehensive geriatric assessment and home-based rehabilitation for elderly people with a history of recurrent non-elective hospital admissions

2006 ◽  
Vol 35 (5) ◽  
pp. 487-491 ◽  
Author(s):  
David J. Stott ◽  
Amanda K. Buttery ◽  
Adam Bowman ◽  
Rona Agnew ◽  
Katriona Burrow ◽  
...  
Keyword(s):  
Elderly People ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Hospital Admissions ◽  
Home Based ◽  
History Of

scholarly journals Multiple acquisitions of STIs: invitation to precision in clinical care and summons to intangibles in laboratory diagnosis

2017 ◽  
Vol 3 (1) ◽  
pp. 3-10
Author(s):  
Kirti Nirmal ◽  
Rumpa Saha ◽  
Vishnampettai G. Ramachandran ◽  
Sambit N. Battacharya ◽  
Shukla Das ◽  
...  
Keyword(s):  
Clinical Care ◽  
Tertiary Care ◽  
Clinical Intervention ◽  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Antibody Detection ◽  
Care Hospital ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Bacterial Agent

Background Co-existence of one sexually transmitted infection (STI) with another viral or bacterial agent may change the classical behavior of the genital infection and may provide the stimulus for reactivation. The objectives of this study were to document and appraise the relevance and importance of co-infection in STIs in their prevailing permutation and combination.Material and methods This cross-sectional study included 200 consecutive patients, attended the STI clinic of a tertiary care hospital in East Delhi with one or more complaints related to STI. Samples were collected, stained, cultured and antibody detection was done.Results A number of STIs patients had significant association with multiple co-infecting agents. Dual coinfection was seen in 53.1%, while ≥ 3 STIs pathogens were seen in18% cases. Importance of serology in detecting subclinical cases is also highlighted in the study.Conclusion Present study highlights the requirement for periodic need based surveillance of STIs for clinical intervention with challenge to clinicians for diagnosing multiple co-infections. The number of subclinical STIs in the present study underscores the importance of serology for detection of common STIs in all patients presenting to the STI clinic.

scholarly journals A clinico-mycological study of onychomycosis at a tertiary care center

2017 ◽  
Vol 8 (1) ◽  
pp. 48-57
Author(s):  
Attar Farhana Iqbal ◽  
Tendolkar Uma Mahesh ◽  
Baveja Sujata Mukesh ◽  
Dhurat Rachita ◽  
Phiske Meghna
Keyword(s):  
Candida Species ◽  
Potassium Hydroxide ◽  
Fungal Infections ◽  
Care Center ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Care Hospital ◽  
Large Bulk ◽  
Causative Agents ◽  
Clinical Consequences

Background: Onychomycosis continues to be worldwide problem constituting a large bulk of cases attending the dermatology outpatient department. Fungal infections of nails have been partly studied,because it has been considered more of a cosmetic problem than a health problem. Although not life threatening, onychomycosis may have significant clinical consequences such as secondary bacterial infection, chronicity, therapeutic difficulties and disfigurement, in addition to serving as reservoir of infection.  Aims and Objectives: To find out the prevalence, etiology and clinico-mycological correlation of onychomychosis among clinically suspected cases.To compare the microscopy findings using potassium hydroxide (KOH) preparation with potassium hydroxide- dimethyl sulfoxide (KOH-DMSO/DMSO) preparation.To compare demographic and clinical data inonychomycosis and fungus negative groupsMaterial and Methods: The study was conducted from October 2011 to October 2013, in the department of Microbiology of a tertiary care hospital in Mumbai, including 204 patients clinically suspected of onychomycosis. Nail scrapings were collected depending upon site, type of nail involvement and subjected for microscopic examination using 20% KOH and KOH DMSO (10-40%), followed by fungal culture.Results: Out of 204 patients, 78 (38.2 %) were diagnosed having onychomycosis, 72 (92.3%) patients were positive by direct microscopy and 45 (57.7%) by culture. DMSO preparation offered a faster clearing of background but in KOH preparation fungal morphology was better maintained even after 24 hours. In culture positive cases, isolation of dermatophytes was most common (42.2%), followed by Candida species (31.1%) and nondermatophytes (26.7%).Conclusion: This concludes that laboratory diagnosis of onychomycosis is essential as many conditions of nail mimic onychomycosis. Though commonest causative agents of onychomycosis are dermatophytes, number of cases caused by Candida species and nondermatophytesare on the rise.Asian Journal of Medical Sciences Vol.8(1) 2017 48-57

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