scholarly journals Clinico-physiological profile of patients of pulmonary impairment after tuberculosis at a tertiary care centre

2018 ◽  
Vol 6 (9) ◽  
pp. 2999
Author(s):  
Gajendra V. Singh ◽  
Antriksh Srivastava ◽  
Vinisha Chandra ◽  
Santosh Kumar ◽  
Rishabh Goel
Keyword(s):  
Pulmonary Tuberculosis ◽  
Exercise Tolerance ◽  
Structural Changes ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Lung Parenchyma ◽  
Tertiary Care Centre ◽  
Physiological Profile ◽  
Pulmonary Impairment

Background: Pulmonary tuberculosis (TB) is a unique infectious disease that more often results in permanent structural changes in the lung parenchyma. It is by virtue of these changes that the patients even after bacteriological cure continue to suffer the after effects of the disease. Objective of study was to assess the clinico-physiological profile of patients of pulmonary impairment after tuberculosis (PIAT) attending S. N. Medical College, Agra, Uttar Pradesh, India.Methods: Over the time period of 2 years, 350 patients of healed pulmonary tuberculosis were identified and studied about their clinico-physiological profile. This profile included age, sex, category of treatment, pulmonary function test pattern, exercising capacity, exercise tolerance and quality of life.Results: It was found that majority of the patients were males, >60 years of age and had taken Category-II treatment. Most of the patients were having an obstructive pattern on PFT, poor exercise tolerance and exercise capacity and a poor quality of life.Conclusions: Patients of healed pulmonary TB continue to experience respiratory symptoms owing to the permanent anatomical changes in the lung conferred by the disease.

scholarly journals A study to assess the clinico-radiological and spirometric proৎile of post tuberculosis patients in a tertiary care centre

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1350-1356
Author(s):  
Kavya S ◽  
Priya Joy ◽  
Gangadharan V
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Lung Parenchyma ◽  
Airway Disease ◽  
Tertiary Care Centre ◽  
Tuberculosis Patients ◽  
Medical College ◽  
Small Airway Disease ◽  
Significant Difference ◽  
History Of

Tuberculosis is an infectious disease which has affected millions of people around the world. Ten million new TB cases were identified globally in 2018, with an estimated 1.2 million deaths.  Lung function impairment often occurs due to the destruction of the lung parenchyma. This causes ventilatory abnormalities, often of obstructive type. Radiological lesions are also a common consequence of pulmonary tuberculosis. This study aims to analyse the various clinical features and assess the spirometric and radiological findings in post TB patients. This is a prospective observational study. All patients visiting the Chest Medicine OPD of Saveetha Medical College and Hospital who had a history of treated pulmonary tuberculosis and were above 18 years of age were included in this study. Patients who had no signs of active Tuberculosis underwent spirometry, and a chest x-ray was taken. Clinical presentation, spirometric parameters and radiological lesion were analysed. Among the 76 patients included in this study, 73.7% were male with most patients aged between 51 to 60 years. 64.5% of the study population were smokers. Dyspnoea (94.73%) was found to be the most common presenting complaint. Obstructive pattern (49%) was found to be the most common type of spirometric pattern with 68.42% having small airway disease. Based on the Wilcox classification, Degree II (47.37%) was the most common extent of the radiological lesion. It was found that there is a statistically significant difference between smokers and non-smokers in post-bronchodilator FEV1 (p=0.037) and FEF25-75 values (p=0.010). This study reveals the presence of post tuberculosis lung impairment in the population with varying presentations and severity. Hence, further studies and interventions are required to improve the quality of life of post tuberculosis patients.

Prevalence and antibiogram of non-fermenting Gram-negative bacilli in blood stream infections: Study in a tertiary care centre, Western Uttar Pradesh, India

2021 ◽  
pp. 004947552097929
Author(s):  
Tarana Sarwat ◽  
Mariyah Yousuf ◽  
Ambreen S Khan ◽  
Dalip K Kakru ◽  
Renu Dutta
Keyword(s):  
Burkholderia Cepacia ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Blood Stream ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Acinetobacter Baumanii ◽  
Blood Stream Infections ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative

Non-fermenting Gram-negative bacilli (NFGNB) are emerging as important cause of blood stream infections. We aimed to determine the prevalence and antibiotic susceptibility pattern of NFGNB isolated from blood of patients with sepsis. We found, in 176 patients, the most common to be Pseudomonas aeruginosa (74) and Acinetobacter baumanii complex (39) followed by Stenotrophomonas maltophilia (16), Sphingomonas paucimobilis (6), Burkholderia cepacia (5) and Ochrobactrum anthropic (1). Generally, organisms showed a good sensitivity towards colistin, carbapenems and fluoroquinolones, whereas cephalosporins were ineffective.

scholarly journals A pilot study comparing pattern of damage sustained among instruments from different surgical units in a tertiary care centre in Nepal – reappraising the role of instrument reprocessing in retaining their value

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 102
Author(s):  
Sunil Munakomi ◽  
Roshan Shah ◽  
Sangam Shrestha
Keyword(s):  
Tertiary Care ◽  
Health Spending ◽  
Pivotal Role ◽  
World Health ◽  
Tertiary Care Centre ◽  
Surgical Equipment ◽  
Surgical Units ◽  
Wear And Tear ◽  
Health Organization

Background: The quality of instruments plays a pivotal role in governing safe operating room culture. The reprocessing system followed in the institution determines their durability thereby ensuring patient safety as well as minimizing health spending. Rigorous reprocessing in a centralized instrument reprocessing department by well trained staff following formulated guidelines helps to achieve the target of “safe surgery saves lives” as formulated by the World Health Organization. Methods: We sought to determine the patterns of wear and tear sustained among sets of surgical equipment from two surgical units that had been sent to the repair department within a year of their purchase. Analysis of similar changes in the joints of the instrument, as well as pattern of fractures sustained was performed. Results: All patterns of wear and tear were common in both the general surgical arm and neurosurgical counterpart, with the exception of fractures and mal-alignments. Similar study was performed examining changes in the joints. Stains were the most commonly observed change pattern in both sets of instruments. Fractures were most frequent in the working ends in both sets of instruments. Conclusion: There is an alarming incidence of wear and tear patterns in the instruments used in the surgical units, even within the first year of their use. This supports the strict implementation of reprocessing guidelines by well trained workers and their quality assessments via audit checks. The quality of the purchased instruments also plays a pivotal role.

scholarly journals Response of leuprolide on gonadal functions of women with overt hypothyroidism: a tertiary care centre study from Uttar Pradesh - India

2019 ◽  
Vol 8 (1) ◽  
pp. 277
Author(s):  
Manish Srivastav ◽  
Alankar Tiwari ◽  
Nihit Kharkwal ◽  
Keshav Kumar Gupta
Keyword(s):  
Human Subject ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Ovarian Response ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Newly Diagnosed ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Healthy Females

Background: Hypothyroidism can cause menstrual disturbances mainly oligoanovualtory cycles and sometimes menorrhagia. It has also been seen to cause subfertility and pregnancy related complications. Various studies have been done to evaluate gonadal dysfunctions in overt hypothyroidism but very few studies are there which have done using a gonadotrophin response in that subset of patients. Present study evaluates the response of leuprolide on gonadal functions of women with overt hypothyroidism in a tertiary care centre at Meerut.Methods: In this study 50 females of age 20 to 40 years with newly diagnosed overt hypothyroidism were taken as cases and age and Body Mass Index (BMI) matched healthy females were taken as controls. Both in cases and controls, basal FSH, LH, estradiol was measured on 2nd day to 5th day of menstrual cycle. Thereafter Leuprolide 20 mcg/kg was given subcutaneously on the same day. Post leuprolide test, stimulated LH, FSH and estradiol were measured. Basal and stimulated values were compared between both groups.Results: Basal LH was significantly higher in controls (8.2±3.2 mIU/L) when compared to cases (6.45±2.75 mIU/L) with a p value 0.03(<0.05). Basal estradiol and FSH levels were found to be nearly similar and non-significant in cases and controls. No significant differences were found between stimulated mean LH and estradiol in both the groups. Leuprolide response after stimulation test was found to be sluggish in patients with overt hypothyroidism compared to normal euthyroid controls. This study is the rare one done on human subject in tertiary care centre of India, however large sample and multicentric trials are necessary before establishing the biochemical results.Conclusions: Pituitary and gonadal (ovarian) response to leuprolide was found to have impaired (decreased) in overt hypothyroidism cases. This is the first study to be done in overt hypothyroid subjects to asses both basal and stimulated gonadotropin levels.

scholarly journals P73 Trends in ultrasound guided musculoskeletal injections at one tertiary care centre over 6 years

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Kunal Lall ◽  
Vivian Ejindu ◽  
Patrick D. W Kiely
Keyword(s):  
Soft Tissue ◽  
Time Pressure ◽  
Waiting Times ◽  
Tertiary Care ◽  
Fold Increase ◽  
Ultrasound Guided ◽  
Tertiary Care Centre ◽  
The Impact ◽  
Effective Service

Abstract Background Ultrasound (US) has brought many benefits into rheumatologic practice, delivery of targeted injections into joints, bursae and other structures. Whilst many joints may be accurately injected in clinic, guided by clinical landmarks, US permits injections into anatomically less accessible sites. We have assessed trends in the number and type of requests for US guided joint or soft tissue injections from the rheumatology department over the last 6 years, and the impact on waiting times. Methods Details of all requests for US guided joint or soft tissue injections were obtained from the St George’s PACS system from 1 January 2013 - 31 December 2018. Review of patient records was conducted to determine whether the referral was routine or urgent, the waiting time between referral and appointment, the joint or structure to be injected, and whether an injection into the requested site was actually performed. Results Table 1 shows the total number of out-patient attendances in rheumatology per year from 2013 - 2018, the number of referrals for US-guided injection, the proportion requested urgently and waiting times for routine and urgent cases. Over 6 years requests for US guided injections have risen 2.3-fold, from &lt;1% to nearly 2% of all out-patient attendances. Of 1834 requests, no injections were given in 420 instances (23%), due to patient preference or lack of indication at time of US. In 2018 of all joint or tendon/bursa injections initiated in rheumatology, 260 (38%) were given in routine clinic time without delay, and 420 (62%) were requested by US with a delay of over 2 months. Conclusion Over 6 years a 33% increase in out-patient clinic workload has been accompanied by a disproportionate 2.3-fold increase in requests for US guided injections, representing &gt;50% of injections initiated by the service. One explanation may be time pressure in clinic. This trend has not been matched by increased radiology capacity, with urgent requests now waiting &gt;6 weeks. This has implications for quality of care, staffing and effective service delivery. The trend to fewer injections in clinic will continue if clinicians become increasingly reliant on radiology colleagues. Disclosures K. Lall None. V. Ejindu None. P.D.W. Kiely None.

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