scholarly journals EPIDEMIOLOGICAL INVESTIGATIONS OF ACUTE WATERY DIARRHEA OUTBREAK DURING JULY-AUGUST 2017 IN AMARPURA, RAWALPINDI - PAKISTAN

2019 ◽  
Vol 9 (2) ◽  
pp. 74-77
Author(s):  
Khurram Shahzad Akram ◽  
Muhammad Wasif Malik ◽  
Mumtaz Ali Khan ◽  
Majid Ali Tahir ◽  
Syeda Shazia Adeel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Water Samples ◽  
Tertiary Care ◽  
Control Measures ◽  
Protective Measure ◽  
Watery Diarrhea ◽  
P Value ◽  
Care Hospital ◽  
District Health ◽  
Acute Watery Diarrhea

Background: On July 24, 2017, two cases suspected of acute watery diarrhea (AWD) were reported from tertiary care hospital, Rawalpindi. District health authorities directed to conduct outbreak investigation, identified risk factors and recommend control measures. Methods: A descriptive followed by age-sex matched case control study (1:3) was done from Jul 27 to Aug 02, 2017. Case definition was "sudden onset of loose watery stools (? 3 in past 24hrs) with any of symptoms i.e. vomiting, nausea, abdominal cramps or fever in residents of Amar Pura from July 19 to August 02, 2017". Active and passive case finding technique were done in addtion to hosptial record review. Total 02 stool and 03 water samples were collected for microbiological testing. Odd ratios computed on 95% confidence interval and P value <0.05. Results: Total 18 cases were identified (mean age: 16 year; range: 02 m-55yrs), predominate were male 2.6:1. Overall attack rate (AR) was 7.2/1000 and preponderate affected age group was 15-24 years (AR: 10/1000). Significantly associated risk factors were; use of untreated municipal water (OR:15, CI: 4.00-73.96) and use of untreated well water (OR:14.52, CI: 3.98-59.99). Use of water from filtration plant was found protective association (OR: 0.12, CI: 0.005-0.750). Laboratory found Vibrio Cholera Serotype Inaba in stool samples and coliforms in water samples. Conclusion: Consumption of contaminated water was most probable cause of outbreak. Use of filtered water was found to be a protective measure. Chlorination of water sources and health awareness sessions on water sanitation and hygiene were done in community.

scholarly journals Risk factors, clinico-epidemiological profile of tuberculosis among children attending a tertiary care hospital: a two year study

2018 ◽  
Vol 5 (3) ◽  
pp. 851
Author(s):  
Ravikumar Tenali ◽  
Naveen Kumar Badri ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Tertiary Care ◽  
Epidemiological Surveillance ◽  
P Value ◽  
Tuberculous Lymphadenitis ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary ◽  
Epidemiological Profile

Background: TB remains as the one among the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease with 0.4 million with HIV. At least 1 million children become ill with TB each year. Children represent about 10-11% of all TB cases. Having knowledge of the risk factors for tuberculosis infection in children is important to evaluate the level of ongoing transmission of infection and to help adapt activities within national TB control programs. The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Methods: The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Results: 98 cases of TB were confirmed out of total 628 with a prevalence of 17.07% in the   study with 78 PTB cases and 20 EPTB. Females were more with male to female ratio of 0.7:1.5-9 years was the most common age group in the study. Statistically significant association was found between old history of ATT, HIV positivity, contact with an open case of TB and malnutrition (p value<0.05). TB meningitis was the most common EPTB (10/20 cases) followed by tuberculous lymphadenitis (5/20). 69.39% (68/98 cases) were smear positive, radiologically 59.18% of cases were positive and Tuberculin skin test was positive in 46.94%.Conclusions: Childhood tuberculosis is a neglected entity in developing countries due to underreporting and difficulties in diagnosis due to variable clinical picture in children. Hence epidemiological surveillance studies in children are required to determine the actual prevalence of pulmonary and extra pulmonary cases of tuberculosis. Increased efforts are required to isolate TB bacilli from body fluids to identify early the childhood cases and manage them to prevent disease burden in the community.

Prevalence, risk factors and antimicrobial susceptibility pattern of extended spectrum β-lactamase-producing bacteria in a tertiary care hospital

2016 ◽  
Vol 27 (2) ◽  
Author(s):  
Dilip Chandrasekhar ◽  
Jaffer Chalilparambil ◽  
Sajitha Mukriyan Kallungal ◽  
Danisha Pattani ◽  
Abin Chandrakumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antimicrobial Susceptibility ◽  
Control Strategies ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
Development Of Resistance ◽  
Extended Spectrum

AbstractThe widespread misuse of antibiotics over the past several decades has been regarded as the contributing factor in the development of resistance toward them. Extended spectrum β-lactamases (ESBLs) are enzymes produced by certain bacteria that can make them resistant to certain antibiotics. Early detection of ESBL strains and judicious use of antibiotics and proper implementation of infection control strategies are essential to prevent the spread of this threat in the community. The study aimed at appraising the prevalence, risk factors and antimicrobial susceptibility pattern of ESBL-producing microorganisms.A prospective observational study was carried out in a tertiary care referral hospital located in Malappuram district of Kerala among inpatients with infection by ESBL-producing bacteria in order to estimate the prevalence, risk factors and their antibiotic susceptibility pattern.Out of the total 1156 patients studied, 118 had confirmed diagnosis on the presence of ESBL-producing microorganisms. Overall, 9.79% of all samples growingHigh prevalence of ESBL-producing organisms is evident in the study setting implicating the necessity to report the ESBL production along with the routine sensitivity reports supplemented with control measures which can assist a clinician in prescribing appropriate antibiotics.

scholarly journals Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Nighat Sultana ◽  
Attia Bari ◽  
Mehwish Faizan ◽  
Muhammad Sarwar
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Tetanus ◽  
P Value ◽  
Care Hospital

Objective: To determine the prognostic factors and outcome of tetanus in children of post-neonatal age admitted in the intensive care unit (ICU) of a tertiary care hospital. Methods: This prospective cross sectional study, carried out in the Pediatric ICU of The Children’s Hospital Lahore from Jan 2013 to March 2017. Children of both genders with age range of two months to 16 years diagnosed clinically as tetanus were included. All 132 patients were scrutinized for all possible risk factors, need for mechanical ventilation and outcome. Data was analyzed by SPSS version 20. Results: Mean age of children was 7.5±3.4 years with male predominance (70.5%). Only (38.6%) received three doses of vaccination but none had booster dose. Trauma (43.2%) encompassed maximum predisposing factor followed by ear or nose prick and ear discharge. Mean duration of ICU stay was 20±13.3 days. Mortality rate was (17.4%). Ventilator support was given to (78.8%). Neurological outcome was normal in (82.6%). Trauma, ear or nose prick in girls and ear discharge were significantly associated with poor outcome and death with p-value of <0.001, 0.011 and <0.001 respectively. Other factors associated with poor outcome were need for mechanical ventilation and neurological impairment with p-value of 0.001 and <0.001 respectively. Conclusion: Tetanus is causing our children to suffer from devastating disease. Vaccination status is not satisfactory and along with trauma, ear discharge and ear or nose prick are identifiable risk factors. To combat these issues large scale vaccination and booster doses remains promising option. doi: https://doi.org/10.12669/pjms.35.5.656 How to cite this:Sultana N, Bari A, Faizan M, Sarwar M. Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.656 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.

scholarly journals Clinical characteristics and factors influencing the outcome of hospitalised COVID-19 patients in a semi-urban primary healthcare center

2021 ◽  
Vol 14 (2) ◽  
pp. 42-54
Author(s):  
Wasim Md Mohosin Ul Haque ◽  
Chinmay Saha Podder ◽  
Nandini Chowdhury ◽  
Md Mohim Ibne Sina ◽  
SKM Shameem Kawser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Outcome ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Rt Pcr ◽  
District Health ◽  
Factors Associated ◽  
Negative Outcome

Background and objectives: Various new manifestations and risk factors for COVID-19 have been unveiled in the course of the current pandemic. Understanding the clinical spectrums as well as the risk factors associated with the adverse outcome of the disease is critical to combat this pandemic. This study was conducted to identify the clinical features, overall outcome and the factors associated with adverse outcome of the hospitalised COVID-19 patients in a semi-urban healthcare setting. Methods: This study was conducted at Debidwar Upazila (sub-district) Health Complex under the Cumilla district from April 2020 to October 2020. Reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients, aged 18 years and above, admitted at the Health Complex were enrolled in the study. All patients were followed till their recovery, referral or death. The data were collected in a pre-designed semi-structured questionnaire that included demographic, epidemiological, clinical and laboratory parameters. Result: Out of 50 RT-PCR positiveCOVID-19 adult participants, 30 (60%) were males and 20 (40%) were females. Twenty-four percent, 36%, and 40% of the patients had mild, moderate and severe disease respectively. The most common clinical symptom was fever (96%), followed by cough (86%) and shortness of breath (60%). Hypertension (54%), diabetes mellitus (40%), bronchial asthma (20%) and chronic obstructive pulmonary disease (COPD, 14%) were the major co-morbid conditions. Of the total cases, 2 (4%) died and 8 (16%) required referral to tertiary care hospital while 40 (80%) recovered. COPD was associated with poor outcome (OR 19; 95% CI: 2.88, 125.31; p < 0.05). Smokers were 7 times more likely to exhibit the negative outcome than non-smokers (95% CI: 1.52, 32.33; p < 0.05). Conclusion: In this study, COPD was associated with a negative outcome. Further study with larger sample should be carried out to determine the spectrum of risk factors. Ibrahim Med. Coll. J. 2020; 14(2): 42-54

scholarly journals Prevalence and risk factors of acid peptic ulcer disease at a tertiary care hospital

2018 ◽  
Vol 5 (4) ◽  
pp. 988
Author(s):  
Manohar Shankarrao Chavan ◽  
M. Bhaktavatsalam
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
General Medicine ◽  
Control Measures ◽  
Outpatient Department ◽  
Care Hospital ◽  
Coffee Intake ◽  
Peptic Disease ◽  
Number Of Patients ◽  
Very High

Background: In day to day practice, at outpatient department of General Medicine, at Mahavir Institute of Medical Sciences, Vikarabad, Telangana, India authors are coming across a significant number of patients with acid peptic disease (APD). This prompted us to carry out the present study. The objective is to study the prevalence, risk factors of acid peptic disease and to give suitable recommendationsMethods: Present study was hospital based cross sectional study carried out at outpatient department of General Medicine for a period of ten months from June 2017 to March 2018 among 307 outpatients.Results: The prevalence of acid peptic disease was found to be very high in the present study i.e. 38.1%. This was very high compared to the available literature. The prevalence of acid peptic disease was significantly associated with increasing age, lower social class, alcohol use, tea use and NSAID use. Acid peptic disease was not found to be associated with sex, residence, literacy, smoking, coffee intake, and obesity.Conclusions: Prevalence of acid peptic disease was found to be very high in the present study. Hence there is a need to institute the preventive and control measures to bring down the prevalence. At the same time the people in the surroundings should be made aware of this health problems and its risk factors.

scholarly journals A study of the risk factors of various arrhythmias in patients with coronary heart disease

2017 ◽  
Vol 4 (5) ◽  
pp. 1369
Author(s):  
Puneet Patil ◽  
Aamera Sait ◽  
Dilip Ratan Patil
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Statistical Significance ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Av Block ◽  
Cross Sectional ◽  
Multiple Risk Factors ◽  
Multiple Risk

Background: Complications like arrhythmias, cardiac failure, cerebrovascular and mechanical complications. Among these complications, arrhythmias are the most common complication of acute myocardial infarction. The objective of this study was to study the risk factors of various arrhythmias in patients with coronary heart disease.Methods: Present study was a hospital based cross sectional study conducted at department of General Medicine of a tertiary care hospital for a period of two years among 102 patients. Detailed history, clinical examination, investigation was done. All patients were followed for one year to assess the outcome among them. All data was entered in the Microsoft Excel worksheet and analyzed using proportions.Results: Arrhythmias were more common with low ejection fraction (72.73%). The overall mortality was 7.84%. Ventricular fibrillation was seen in 50% of the patients who did not receive thrombolytic therapy. First-degree AV block and second-degree AV block were present in 6.25% and 7.50% respectively and did not affect the mortality while complete heart block was present in 8.75% and mortality rate of 28.57% with right ventricular involvement. Risk factors like smoking, alcohol, hypertension, diabetes mellitus and obesity had higher incidence of arrhythmias but was not found to have any statistical significance (p >0.05). However, patients having multiple risk factors strongly associated with the high mortality in statistically significant manner (p value 0.0006).Conclusions: Patients with risk factors like smoking, alcohol, hypertension, diabetes mellitus and obesity had higher incidence of arrhythmias. Multiple risk factors increase the incidence of both arrhythmias and mortality (67% mortality with 4 risk factors and 75% mortality with 5 risk factors).

scholarly journals Association of Diabetes and Hypertension as risk factors with Ischemic Heart Disease among patients visiting a Public Sector Tertiary Care Hospital of Karachi, Pakistan

2021 ◽  
Vol 10 (4) ◽  
pp. 215-219
Author(s):  
Zulfiqar Ali Shaikh ◽  
Javeria Shamim ◽  
Akmal Khurshid Bhatti ◽  
Sahar Soomro ◽  
Zareen Kiran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Family History ◽  
Public Sector ◽  
Ischemic Heart Disease ◽  
Sedentary Lifestyle ◽  
Tertiary Care ◽  
Ischemic Heart ◽  
P Value ◽  
Care Hospital

Background: Ischemic Heart Disease (IHD) is a leading cause of morbidity and mortality worldwide. IHD results from myocardial ischemia, and occurs whenever perfusion outgrows the demand. Though lethal, but can be prevented by modification of predisposing conditions, most important are diabetes and hypertension. Almost fifty percent of IHD patients are found hypertensive with or without being diabetic. The objective of the study was to determine association of diabetes and hypertension as risk factors for IHD patients Methods: This was a hospital-based cross-sectional study that included 199 IHD patients of 35-70 years age, visiting Civil Hospital Karachi, a tertiary care public sector hospital, from September 2017 to January 2018 by using non-probability convenient sampling technique. The patients were approached in the hospital and briefed about the purpose of the study. A pre-tested, structured close ended questionnaire was used to collect the data. Data entry and analysis were done by using SPSS version 20.0. A p-value of <0.05 was considered as statistically significant. Results: Out of 199 participants, 156 (78%) were males while 43 (22%) were females; 119 60%) were 56-65 years of age. Family history of ischemic heart diseases was unremarkable in 126 (63%) patients. In total, 122 (61%) were diabetic; among them, 24 were of less than 40years and 98 of more than 40years of age. The older age of the diabetics had a direct association with the risk of IHD (p-value <0.05). About 83% had a non-significant family history for diabetes; and 83% of the total study participants were having a sedentary lifestyle. Out of 199, 166 (83%) had never checked their blood pressures earlier. The lifestyle, diet, addiction, and duration of hypertension had a strong association with IHD (p-value <0.05). Conclusion: IHD occurs more frequently in males of 56-65 years age, with insignificant family history for IHD and diabetes. The IHD is associated with hypertension and diabetes along with sedentary lifestyle, unhealthy diet and smoking/tobacco addiction.

scholarly journals Study of pregnancy outcome of threatened abortion and its correlation with risk factors in a tertiary care hospital of Mumbai, India

2018 ◽  
Vol 7 (11) ◽  
pp. 4598
Author(s):  
Dipali S. Sivasane ◽  
Rekha G. Daver
Keyword(s):  
Risk Factors ◽  
Maternal Age ◽  
Pregnancy Loss ◽  
Demographic Data ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Number Of Patients ◽  
Significant Difference ◽  
Threatened Abortion

Background: Early pregnancy loss is very common and, in most cases, it can be considered as nature’s method to select for a genetically normal offspring. Threatened abortion is a relatively common complication during pregnancy, occurring in approximately 20% of all pregnancies. Maternal age, Outcome of previous pregnancies, health of mother, any infection etc can be decisive factors in the risk of pregnancy loss.Methods: The present study was a cross sectional study where patients admitted with threatened abortion were interviewed using pretested semi-structured questionnaire after the treatment. Outcome of pregnancy was recorded. Their basic socio-demographic data along with possible risk factors were recorded. TORCH Ig M and Ig G were done in all patients.Results: Out of 95 patients admitted with threatened abortion, 42 (44%) patients undergone abortion whereas in 53 (56%) patients, pregnancy was continued. Out of total 60 patients admitted with the complain of only vaginal spotting, in 39 pregnancy continued and in 21 patients pregnancy was aborted. (p-value<0.05). 50.52% were from age group of 21 to 25 years of age. It was also seen that after 35 years of age, significant number of patients aborted. Out of these 11 patients with high BMI, pregnancy was continued only one patient. Out of total 20 patients positive for IgM of toxoplasma infection, pregnancy was aborted in 13 (65%) patients. Out of total 15 patients positive for IgM of cytomegalo virus infection, pregnancy was continued in 11 (73.3%) patients.Conclusions: Patients of threatened abortion with only symptom of spotting per vagina have good chances of continuation of the pregnancy. Increased maternal age above 35, Overweight and bad obstetric history are also associated with pregnancy loss. Though there was no statistically significant difference it was evident that among all TORCH infections, IgM toxoplasma and Rubella are associated more with pregnancy loss.

scholarly journals Risk factors for ectopic pregnancy; an institutional study in a tertiary care hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4741
Author(s):  
Ranjita Ghadei ◽  
Swayamsiddha Mohanty ◽  
Sushree Sovana Mishra ◽  
Debashis Giri
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Previous History ◽  
Diagnostic Tools ◽  
P Value ◽  
Care Hospital ◽  
Pregnancy Risk ◽  
History Of ◽  
A Prospective Study

Background: Ectopic pregnancy is the leading cause of maternal death during the 1st trimester of pregnancy, accounting for approximately 10% of all pregnancy related deaths. A better understanding of ectopic pregnancy risk can help prevent its occurrence. The present study was designed to evaluate the ectopic pregnancy risk factors and their strength of association with ectopic pregnancy at a tertiary care hospital.Methods: It was a prospective study with 104 cases of ectopic pregnancy and 125 controls conducted in the Department of Obstetrics and Gynecology, SCB Medical College, Cuttack for a period of 1 year. Detailed history suggestive of risks factor for ectopic pregnancy, menstrual and obstetrics history was taken. General, systemic, abdominal and vaginal examination was done. Diagnosis of ectopic pregnancy was confirmed by clinical examination, urine pregnancy test, ultrasonography and culdocentesis and only confirmed cases were included in the study group. Healthy pregnant women were taken as control group.Results: The study revealed that the risk of ectopic pregnancy was associated with the traditional risk factors including previous EP [Adjusted odds ratio (AOR) = 9.98, 95% CI: 0.89-11.1%], previous infertility (AOR= 7.29, 95% CI:2.53-21.0) and previous history of sterilization (AOR=12.47,95% CI: 3.50 - 44.4) and previous history of abortion (AOR= 3.10, 95% CI: 1.53-6.30). Age comparison between cases and controls revealed that the ODDS of having ectopic pregnancy was 4 times in the age group 30 to 35 years as compared to uterine pregnancy and this difference was statistically significant (P value = 0.007).Conclusions: Risk factors such as previous ectopic pregnancy, induction of ovulation, intra uterine device usage, abortion as well as increased maternal age along with recent diagnostic tools aid in early detection of ectopic pregnancy in women resulting in proper and timely treatment.

scholarly journals Proportion and risk factors of postnatal depression among women delivering in a government tertiary care hospital in Kerala, India

2021 ◽  
Vol 10 (6) ◽  
pp. 2395
Author(s):  
Naheeda Mohammed K. T. ◽  
Lalithambica Karunakaran ◽  
Varghese P. Punnoose
Keyword(s):  
Risk Factors ◽  
Postnatal Depression ◽  
Child Outcomes ◽  
Tertiary Care ◽  
Depression Scale ◽  
Tertiary Hospital ◽  
P Value ◽  
Care Hospital ◽  
Early Screening ◽  
Kerala State

Background: The burden of postpartum depression is significant because it remains unrecognized and it not only affects the mother adversely but also has a negative consequence on the family life and the development of the infant. This research aims to aid the early diagnosis of postnatal depression using Edinburgh postnatal depression scale (EPDS) and the psychosocial and reproductive risk factors of postnatal depression among women delivering in a tertiary hospital in Kerala state, India.Methods: 500 women were subjected to a standard questionnaire for assessing psychosocial and reproductive characteristics. The diagnosis of postnatal depression was made using a pretested and validated Malayalam version of EPDS with a score cut off of 13 or more.Results: The proportion of postnatal depression six weeks after delivery at TD Medical College, Alappuzha was found to be 8.6%. Marital harmony (p value=0.002) was significantly associated with postnatal depression. Diabetes (p value=0.037), hypertensive disorders (p value=0.013), antepartum hemorrhage (p value=0.036), neurological disorders (p value <0.001), type of delivery (p value=0.042), postpartum complications (p value=0.003), mode of infant feeding (p value=0.001), infant illness (p value=0.001), symptoms of maternity blues (p value <0.0001), premenstrual syndromes (p value=0.008) and infertility treatment (p value=0.03) were significantly associated with postnatal depression.Conclusions: Early screening of the women and counselling of women and their family will reduce the maternal morbidity and adverse child outcomes.

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