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CML is characterized by the presence of a BCR-ABL1 fusion transcript. Several guidelines have been published for its detection and molecular monitoring. Here, a case is described of chronic myeloid leukemia presenting in the blast phase with a rare variant transcript, with a discussion on possible red flags in its detection and genetic testing and description of the patient's clinical characteristics. This case highlights the pitfalls of using real-time quantitative reverse-transcription polymerase chain reaction (RQ-PCR) for diagnosis of CML, especially when the clinical picture and the test results are discordant.
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Objective: To assess the prevalence of hypertension in children with infrequently relapsing nephrotic syndrome (IRNS) and its association with dyslipidemia, and end organ damage including left ventricular hypertrophy (LVH), at relapse and after steroid induced remission. Methods: Prospective observational study conducted in 83 children aged 1-12 years with IRNS, presenting in relapse. Blood pressure, fundus examination, blood and urine investigations were done at relapse and then at 4 weeks of therapy. Echocardiography at 4 weeks was performed for assessment of LVH and relative wall thickness (RWT) for concentric geo-metry (CG). Results: 27 patients (32.5%) developed hypertension, out of which 21 patients (25.3%) had stage I hypertension. Hypertension in first episode (63.0%, P<0.01) and in previous relapses (87.5%, P<0.001) was significantly associated with hypertension in the current episode. 12 patients had a positive family history of hypertension, of which 8 (66.7%) were classified under the hypertensive group (P=0.016). Concentric geometry (CG) was found in 28% of hypertensive and 5.5% of non-hypertensive children (P=0.011). On regres-sion analysis, a lower Up:Uc at the time of relapse was found to have a protective role for development of hypertension. Conclusion: One third children with IRNS had hypertension at relapse and a high proportion of hypertensive patients had CG pattern on echocardiography.
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Background: Preeclampsia is a multisystem disorder characterized by new onset of hypertension systolic blood pressure ?140 mmHg and/or diastolic blood pressure ?90 mmHg and proteinuria >300 mg/24 h arising after 20 weeks of gestation in a previously normotensive woman and associated with significant maternal and neonatal morbidity and mortality worldwide. Women with preeclampsia have an increased rate of cesarean section consequent upon the high incidence of intrauterine growth restriction, fetal distress, and prematurity. The aim of this study was to determine and compare maternal & neonatal outcome among pre-eclamptic women following caesarian delivery under general and spinal anesthesia. Material & Methods: This was a comparative observational study and was conducted in the Department of Anesthesiology of Holy Family red crescent Medical College Hospital, Dhaka, Bangladesh during the period from February,2020 to February,2023. In this study we included 250 preeclamptic women undergoing cesarean delivery. The patients were randomly divided into two groups – GA group (Patients who were given general anesthesia) & SA group (Patients who were given spinal anesthesia). Results: In total 250 patients from both the groups completed the study. In our study we found majority (44.8%) of our patients were aged 28-32 years. The mean age was 27.13 ± 3.76 years. Majority (62.8% ) of our patients were cases of emergency caesarean delivery & 37.2% were elective caesarean delivery classes. Most of the students (41.2%) used magnesium sulfate. Intraoperative systolic BP, diastolic BP was significantly lower in SA group than GA group. We found headache, vomiting, fever and wound gaping, postpartum hemorrhage & lower respiratory tract infection was significantly higher in GA group. On contrary, hypotension & pulmonary edema was higher in SA group. Apgar score at 1st, 5th & 10th minutes was significantly higher in GA group than SA group. In GA group, neonatal mortality at 48 h was 10.4% whereas it was 4.8% in SA group. Conclusion: In our study, we found intra-operative blood pressure and pulse rate was observed significantly higher in GA group than SA. Severe preeclamptic mothers receiving general anesthesia and their babies required more critical care support. Maternal as well as neonatal mortality was significantly higher with general anesthesia. Therefore, spinal anesthesia is a safer alternative to general anesthesia among women with severe preeclampsia following caesarean delivery with less postoperative morbidity and mortality.
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Background: Many surgeries can be performed with spinal anesthesia (SA) or general anesthesia (GA). However, there are only limited and confounding data available regarding costs and anesthesia-related times. Hip or knee replacement are common orthopedic surgeries that can be performed using SA or GA without differences regarding mortality or morbidity. Observational studies have suggested that spinal anesthesia may be associated with lower risks of death, delirium and major medical complications and with shorter lengths of stay in the hospital than general anesthesia. The aim of this study was to assess and compare the effects of spinal versus general anesthesia on postoperative outcomes in patients undergoing orthopedic surgery. Material & Methods: This was a comparative observational study and was conducted in the Department of Anesthesiology of Holy Family red crescent Medical College Hospital, Dhaka, Bangladesh during the period from March,2021 to March,2023. In this study we included 200 patients undergoing orthopedic surgery. The patients were randomly divided into two groups – Group A (Patients who were given general anesthesia) & Group B (Patients who were given spinal anesthesia). Results: In total 200 patients from both the groups completed the study. In our study we found majority (44.5%) of our patients were aged 60-69 years and most of our patients were female (56%) compared to male (44%).The mean age of our patients was 61.73 ± 7.92 years. The mean BMI was 31.67±3.24 kg/m.2Among all patients ,48% had mild systemic disease and followed by 31.5% had severe systemic disease. Majority (43.5%) of our patients had hypertension, 31% had diabetes. Vomiting was found 47% in group A on contrary only 23% had vomiting in spinal group. We found the mean anesthesia induction time was significantly higher in spinal group. Anesthesia time was lower in spinal group while PACU time was higher in group B. Time duration of surgery was significantly lower in spinal group. After 24 hours, spinal group showed less pain score than general anesthesia group. Conclusion: In our study, we found that SA is associated with less fixed and variable costs and lower postoperative pain scores during the stay in the PACU. Therefore, SA is a more reasonable alternative to GA in the immediate postoperative period for patients undergoing hip or knee replacement. When compared to general anaesthesia, spinal anaesthesia provides better operating circumstances, better postoperative pain control, and faster postoperative recovery.
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Background: Acute coronary syndrome (ACS) is a significant cause of morbidity and mortality worldwide. Identifying the risk factors, clinical outcomes, and complications of ACS patients is crucial for optimal patient management and resource allocation. This study aimed to investigate these factors in a tertiary care hospital in Bangladesh. Material & Methods: This cross-sectional observational study was conducted with a sample of 100 ACS patients at the Department of Cardiology, Cumilla Medical College Hospital, Cumilla, Bangladesh. The study duration was 6 months, from March 2013 to August 2013. Data were collected on socio-demographic characteristics, physical measurements, risk factors, presenting symptoms, ACS types, and outcome complications. Descriptive statistics were used to analyze the data. Results: The study population comprised 76% males and 24% females, with a mean age of 55.4 years. The most prevalent risk factors were smoking (59%), hypertension (41%), and diabetes mellitus (10%). Chest pain was the most common presenting symptom (86%). STEMI (48%), unstable angina (44%), and NSTEMI (8%) were the identified ACS types. Complications observed included heart failure (9%), cardiogenic shock (8%), conduction defects (10%), and arrhythmias (13%), with no reported deaths. Conclusion: Our findings emphasize the importance of addressing modifiable risk factors such as smoking, hypertension, and diabetes mellitus through targeted interventions and public health initiatives. Additionally, the study highlights the need for healthcare providers to be aware of both typical and atypical presentations of ACS to facilitate prompt diagnosis and treatment. Further research with larger, multicenter studies is needed to better understand the complexities of ACS risk factors and outcomes in Bangladesh and other low- and middle-income countries
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Background: Coronary Heart Disease (CHD) is one of the largest contributors to mortality and morbidity worldwide. Globally, CHD accounts for 17.5 million deaths in 2012, with over 75% of deaths occurring in developing countries. By 2015, 16% of all female and male deaths were caused by CHD. Dyslipidemia is the most common risk factor of CHD for the excessive level of lipids in blood. Most dyslipidemias are hyperlipidemias in developing countries; that is, an accumulation in blood lipids. CHD was 18 times more likely to grow according to hypertension with dyslipidemia category than with non-dyslipidemias. The aim of this study was to assess the effect of dyslipidemia associated with hypertension for coronary heart disease and identify risk factors for CHD among cardiac patients. Material & Methods: This was a case control study and was conducted in the Department of Medicine, LABAID Specialized Hospital, Dhaka, Bangladesh during the period from May,2022 to March,2023. We included 170 cardiac patients in our study. The patients were divided into two groups – Case group (Patients diagnosed with CHD) & Control group. Results: In total 170 patients from both the groups completed the study. In our study we found most of our patients were male (58%) compared to female (42%). We found the mean age was 46.1±11.3 & 47.1±9.3 years in case & control group respectively. Family history of hypertension was significantly higher in case group (52%). Among all patients, BMI was higher in case group. Cholesterol, systolic & diastolic bp was found significantly higher in case group than control group. HDL was found lower & LDL was found higher in case group. Among 85 cases, majority (68%) had dyslipidemia associated with hypertension. We found dyslipidemia was 55% & 36% in case & control group respectively. Hypertension was also found significantly higher in case group. Age ? 60 years, family history of CHD, smoking, diabetes & obesity were also individual risk factors of CHD among cardiac patients. In dyslipidemia with hypertension group 68 patients were diagnosed with CHD which is higher than non-hypertension group. Conclusion: In our study, we found that dyslipidemia, hypertension, age ? 60 years, family history of CHD, smoking, diabetes & obesity are individual risk factors of CHD development. Relationship of dyslipidemia with coronary heart disease in hypertension is significant. We also found dyslipidemia with hypertension is an established risk factor of prime importance that increased the risks of CHD among cardiac patients
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Introduction: Mucormycosis is an angio-invasive fungal infection that increased significantly during the 2nd wave of the Covid-19 pandemic in India. The rise of cases was attributed to inflammatory changes, poor quality oxygen, immune suppression, and corticosteroid therapy. Case Presentation: This case study reports the history, treatment, and rehabilitation of a case of post-Covid-19 mucormycosis infection. The patient was admitted to the hospital following respiratory distress, at the beginning of the 2nd Covid-19 wave in India. Intravenous antibiotics, steroids, and moist O2 were administered, intensive support was provided and the patient was discharged after 13 days. Following extraction of 17, the patient reported signs of oro-antral communication which was managed by performing antral lavage and buccal advanced flap closure. Histopathological investigation of tissue salvaged during the procedure revealed the presence of fungal hyphae. Management and Prognosis: Following diagnosis, anti-fungal medication was prescribed, and a maxillectomy was performed to remove the affected tissue. On follow-up, the tissue healed with no further complications or symptoms, and rehabilitation was performed using an obturators and are movable complete denture. Histopathological investigations were carried out on the tissue salvaged during maxillectomy which confirmed Mucormycosis infection. Conclusion: The importance of histopathological investigation in the diagnosis of any infectious disease is enumerated in this paper
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Background: Body cavity fluids are evaluated by cell block (CB) technique. In conventional cytological smears (CS), appropriate identification of the cells as either reactive mesothelial cells or malignant cells is a diagnostic problem. In CB method, there is increase in cellularity, so it gives more morphological details of cells and improving the sensitivity of diagnosis. Sections obtained by CB method are also can be stored for future study like immunohistochemistry (IHC). Aims and Objectives: The aim of the study was to determine the diagnostic efficacy of CB technique over conventional CS and to study of IHC in CB of malignant pleural effusion. Materials and Methods: This will be institution-based, cross-sectional, and observational study. The pleural fluid (except blood and pus) obtained by thoracocentesis from both male and female patient (>18 years of age) 100 cases was included in the study. Pleural fluid mixed with blood/pus, fluid from cystic lesion, and inadequate sample (<15 ml vol.) were excluded in the study. Results: Association between architectural pattern in CB versus architectural pattern in cytology smear showed statistically significant value Chi-square: 201.7417, P < 0.0001. Conclusion: We may conclude that CB technique is better than conventional cytology smear technique especially in case of malignant pleural effusion. It increases true positive cases and decreases false negative cases. It also increases cellularity, maintain architectural pattern, and cellular morphology.
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Background: Malaria is one of the most severe public health problems worldwide. India contributes a substantial burden of malaria. It can cause several complications. Aims and Objectives: This study was conducted to determine the association of parasitemia of current malaria with age of patients, hemoglobin level, liver function test (LFT), platelet count, previous history of malaria, and relapse/recrudescence of malaria up to 1 year. Materials and Methods: An observational study conducted in hospital settings included thin and thick smear preparation with Leishman’s staining to determine the parasitemia as per the WHO guidelines from the blood samples of 280 malaria parasite dual antigen (MPDA) kit positive patients and their details were taken during study period of 2 years. Hemoglobin, LFT, and platelet count were tested and they were correlated with parasitemia. The previous history of malaria was taken and follow-up was done up to 1 year for relapse/recrudescence and their association with parasitemia in current disease was evaluated. Statistical tool R was used for data analysis. Results: Age group 20–40 years was most commonly affected with maximum mean percentage parasitemia. Higher parasitemia was associated with higher grade of anemia, LFT derangement, and thrombocytopenia. Disease severity was maximum for mixed infection followed by falciparum and vivax malaria. About 9.28% of patients with the previous history of malaria developed lower parasitemia in current infection. Relapse rate in vivax malaria –2.325% and recrudescence rate in falciparum malaria–12.5%. Conclusion: Malaria parasitemia should be reported routinely as it carries prognostic importance.
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Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as ‘a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.’ The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms ‘frictional dermatitis,’ ‘friction and skin,’ ‘dermatoses and culture,’ ‘clothing dermatitis,’ ‘friction melanosis,’ ‘PPE induced dermatoses in COVID-19 era,’ etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.
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Background: Urinary tract infections (UTIs) are amongst the most common bacterial infections, affecting about 150 million individuals per year.Urinary tract infection (UTI) is one of the most common diseases in human societies which occur in women more than men. Women of all ages are more likely to experience such an infection than men, while half of them may be affected by a uropathogen once in their lives, and 25-30% may develop recurrent UTIs not associated with any functional or anatomical abnormality. The aim of this study was to explore the prevalence of antibiotic resistance of urinary tract infections in immunocompromised patients. Material & Methods: This was a retrospective observational study and was conducted in the Department of Medicine of Dhaka Central International Medical College and Hospital, and National Institute of Kidney Diseases & Urology, Dhaka, Bangladesh during the period from June, 2021 to June, 2022. We included 70 immunocompromised patients with UTI. Results: In our study we found 44% patients were aged between 18-30 years old and 83% of our patients were female. Among all respondents, 58 patients were culture positive. We found 38% & 62% and 33% & 67% had history of upper & lower UTI in female and male patients respectively, 29% & 36% and 17% & 25% had urethritis & cystitis in female and male patients respectively. We found culture positive patients with E. coli (41%), Klebsiella spp.(19%), Enterobacter spp.(16%) and 12% with Pseudomonas spp in our study. We found amoxicillin showed resistance to E. coli (58.3%), Staphylococcus (75%), & Klebsiella (36.4%) and amikacin showed resistance mostly to E. coli(50%), Klebsiella (54.5%) & Pseudomonas (42.9%). Conclusion: In our study, we found the most common MDR pathogen among patients with UTI in our institution was E. coli & Staphylococcus. We discovered that being above 40 years old, having DM, CKD and previously received antibiotic medication inappropriately were risk factors for the development of MDR infection. Given the high prevalence of multidrug resistant uropathogens among immunocompromised patients, the growth in Penicillin resistance is alarming. We discovered the significant incidence of MDR bacterial strains, adherence to currently suggested empiric therapy is extremely challenging and is linked with high failure rates.
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Background: Ocular morbidity with an early onset can have a significant impact on the long-term development of an individual. Hence, careful assessment of visual functions early on is very important. However, testing infants always poses a challenge. Standard tools to assess infants’ visual acuity, ocular motility, and so on rely on the clinician’s quick subjective judgments of an infant’s looking behavior. Eye movements are usually observed from head rotations or spontaneous eye movements in infants. Judging eye movements in the presence of strabismus is even more challenging. Purpose: This video shows a 4-month-old infant’s viewing behavior captured during a visual field screening study. The recorded video aided in the examination of this infant that was referred to a tertiary eye care clinic. The additional information captured through the perimeter testing is discussed. Synopsis: The Pediatric Perimeter device was developed to address visual field extent and gaze reaction time assessment in the pediatric population. As a part of a large-scale screening study, infants’ visual fields were tested. During this screening, a 4-month-old infant presented with a ptosis in the left eye. The infant was consistently missing the light stimuli presented in the left upper quadrant in the binocular visual field testing. The infant was referred to a tertiary eye care center to a pediatric ophthalmologist for further examination. During clinical examination, the infant was suspected to either have congenital ptosis or monocular elevation deficit. But the diagnosis of the eye condition was unsure owing to the poor cooperation of the infant. With the aid of Pediatric Perimeter, the ocular motility was consistent with limitation of elevation in abduction, indicating a possible monocular elevation deficit with congenital ptosis. The infant was also noted to have Marcus Gunn jaw-winking phenomenon. The parents were assured and asked for a review in 3 months. In the subsequent follow-up, the Pediatric Perimeter testing was performed, and the recording showed a full extraocular motility in both eyes. Hence, the diagnosis was changed to only congenital ptosis. The probable explanation for missing the target in the left upper quadrant in the first visit is postulated further. The left upper quadrant is the superotemporal visual field of the left eye and the superonasal visual field of the right eye. As the left eye had ptosis, the superotemporal visual field could have been obstructed and hence the stimuli missed. The normative extent for the nasal and superior visual field is just about 30° for a 4-month-old infant. Hence, the right eye also perhaps missed the stimuli in its superonasal visual field extent. This video highlights the utility of the Pediatric Perimeter device in providing a magnified view of the infant’s face along with greater visibility of ocular features from the infrared video imaging. This can potentially help the clinician to easily observe different ocular/facial abnormalities such as extraocular motility disorders, lid functions, and in identifying unequal pupil size, media opacities, and nystagmus. Highlights: The presence of congenital ptosis in younger infants might predispose as superior visual field defect and could also masquerade as a limitation in elevation.
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Purpose: To analyze the correlation between the mean retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness with axial length and refractive errors among children aged 5–15 years. Methods: This cross?sectional, observational study was done on 130 eyes of 65 consecutive subjects with refractive errors. The patients were evaluated for RNFL thickness and macular GCL thickness using spectral domain? optical coherence tomography. Results: One hundred and thirty eyes of 65 subjects aged between 5 and 15 years were divided into three groups based on their spherical equivalent in diopters (D). The children with a spherical equivalent of ??0.50 D were considered myopic, ??0.5 to ?+0.5 D were considered emmetropic, and ?+0.50 D were considered hypermetropic. RNFL thickness and GCL thickness were correlated with age, gender, spherical equivalent, and axial length. The mean global RNFL thickness was 104.58 ?m ± 7.567. Conclusion: There exists a negative correlation between RNFL thickness and macular GCL thickness with increasing severity of myopia and increase in axial length, and the possible reason could be stretching of the sclera, which further leads to stretching of the retina, resulting in thinner RNFL and macular GCL thickness
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Nevus of Ota is an uncommon dermal melanosis in the Indian subcontinent and is rarely associated with capillary malformations, classified as type II phakomatosis pigmentovascularis (PPV). It usually presents unilaterally as mottled, slate blue, or dark bro wn macules; bilateral presentation is only seen in a few cases. A 20 - year female presented to Dermatology OPD of a tertiary hospital with bilateral nevus of Ota involving the cheeks, temples, nose, forehead, and sclera of the eyes for one year. She also ha d a port wine stain on the right arm, forearm, back, bittock, and thigh since birth without any other systemic involvement. We treated nevus of Ota with six sessions of 1064 nm picosecond laser every month at 0.8 J/cm 2 with significant improvement in the appearance of the lesions and no adverse effects. This case highlights the importance of thoroughly examining pigmented lesions for additional cutaneous findings and the potential use of a 1064 nm picosecond laser to tr eat such lesions.
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Background: Work?related musculoskeletal disorders (WMSDs) are the second most common cause of disability, accounting for 17% of all Years lived with a disability (YLDs) worldwide. Healthcare professionals, especially dentists, are known to be at a higher risk of WMSDs. Therefore, this study aims to determine the point and period prevalence of WMSDs among dentists and to assess the risk factors for WMSDs, including workstation analysis. Methods: This cross?sectional study was conducted among 120 dentists from three dental colleges in Gujarat (Ahmedabad and Gandhinagar), India. A structured questionnaire was used to collect sociodemographic and occupational history along with pre?validated standardized tools such as the Nordic Musculoskeletal Questionnaire (NMQ), Rapid Entire Body Assessment (REBA) score sheet and Quick Exposure Checklist (QEC). Data analysis was performed using SPSS version 20. Results: The period prevalence of MSDs and WMSDs were 85% and 75.8% respectively, and the point prevalence was 39.2% and 23.3% respectively. Prosthodontists reported the highest prevalence of WMSDs. The neck (64.7%) was the most commonly affected area. A statistically significant result was obtained between MSDs and BMI (P = 0.02), qualification (P = 0.01) and between WMSDs and duration of work in the sitting posture (P = 0.03). Conclusions: The prevalence of both MSDs and WMSDs was found to be high. Dentists with higher BMI, higher qualifications, lack of breaks, having poor workstations and higher REBA and QEC scores, whose job tasks involve continuous inspection, frequent bending of elbow joints, frequent repetitive motions, tasks that require them to reach distances greater than 20 inches and tasks that involve twisting of the waist are at a higher risk of developing MSDs
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Background: Population-based screening coverage for breast and cervical cancer screening in the community is inadequately reported in India. This study assessed screening rates, awareness, and other factors affecting screening, among rural women aged 25� years in Vellore, Tamil Nadu. Methods: Women aged 25� years, from five randomly selected villages of a rural block were included in this cross-sectional study in Vellore, Tamil Nadu. Households were selected by systematic random sampling, followed by simple random sampling of eligible women in the house. A semi-structured questionnaire was used to assess screening practices, awareness, and other factors related to cervical and breast cancer. Results: Although 43.8% and 57.9% were aware of the availability of screening for cervical and breast cancer respectively, screening rates were only 23.4% (95% confidence interval [CI]: 18.4-28.4%) and 16.2% (95% CI: 11.9-20.5%), respectively. Adequate knowledge (score of ?50%) on breast cancer was only 5.9%, with 27.2% for cervical cancer. Only 16.6% of women had ever attended any health education program on cancer. Exposure to health education (breast screening odds ratio [OR]: 6.89, 95% CI: 3.34-14.21; cervical screening OR: 6.92, 95% CI: 3.42-14.00); and adequate knowledge (breast OR: 4.69, 95% CI: 1.55-14.22; cervix OR: 3.01, 95% CI: 1.59-5.68) were independently associated with cancer screening. Conclusion: Awareness and screening rates for breast and cervical cancer are low among rural women in Tamil Nadu, a south Indian state with comparatively good health indices, with health education being an important factor associated with screening practices.
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Introduction: Continuous procurement of various equipments in the hospitals is essential to keep up with global progress of healthcare services. In public sectors, procurement process largely depends on budget sanctions and also by a number of formal procedures and rules which leads to delayed procurement. With this prevalent scenario, the present study was carried out to evaluate the procurement of two major equipments in an apex tertiary care institute using Project Evaluation and Review Technique (PERT). Objective: This study was done to evaluate the procurement of two major equipments using PERT in a tertiary care institute. Method: This study was conducted using Operational Research technique in an apex tertiary care institute i.e., medical college and hospital, in one of the North Eastern states of India. All the procurements related to equipments in that teaching hospital initiated in the financial year 2021 were listed. Out of them, two procurement files were selected by simple random sampling; procurement of Operating Table and Bio Safety cabinet Level – III. Project Evaluation and Review Technique (PERT) was applied to calculate the possible reduction in time in the whole procurement process. Results: The present study showed that procurement of Operating table took 185 days where minimum 8 days could have been saved and procurement of Bio-Safety cabinet Level-III was completed by 702 days where minimum 196 days could have been saved. Conclusion: Application of PERT in this procurement evaluation process can play significant role by calculating critical path and predicting the possible delay.
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Post Covid complication occurs in individuals with a history of con?rmed covid-19 infection, that develop within 3months of onset of COVID-19 illness, last for at least 2months and cannot be explained by alternative diagnosis. We aim to estimate the magnitude of post covid complications and its association with risk factors. A follow up study was conducted among 250 COVID19 positive patients from July 2021 to Jan2022. These patients were interviewed telephonically at 3rd month & 6th month after recovery. Majority of post COVID symptoms identified were fatigue (29.6%), anosmia (26.8%) & ageusia (15.2%). At least one of these symptoms was present in 67.6% and 28% patients at 3rd and 6th month post infection respectively. Other clinical features included insomnia (8%), skin rashes (7.6%) and mood disorders (4%). Systemic involvement was seen in 1.2% as new onset hypertension. No significant gender difference was identified in any of the symptoms (?2=0.24, p=0.6). Risk factors associated in developing long COVID-19 were high BMI[RR=1.2], age >60yrs [RR=1.3], poor vaccination status [RR=1.45]and long duration of illness (>14 days) [RR=1.4]. 4 deaths (1.6%) were reported among 8.8% hospitalized patients having severe comorbidities (e.g. Coronary artery disease). Nearly 2/3rd patients were having one or the other symptoms at the end of the 3rd month and 1/4th at the end of 6th months. Also, death during the post COVID period, strongly suggests continuous follow up visits for high risk patients and spreading public awareness to seek health care facilities for follow up.
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Purpose: To report the clinico?demographic profile of rhino?orbito?cerebral mucormycosis (ROCM) in patients during the “second wave” of the COVID?19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. Methods: Cross?sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID?19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. Results: A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID?19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty?six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. Conclusion: Our data from eastern India reinforces the relationship between COVID?19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.
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Chilaiditi’s sign is a rare radiological diagnosis characterized by colonic interposition between the diaphragm and the liver, and when symptomatic it is known as Chilaiditi’s syndrome. We report that the case of a 55-years-old male, who was referred to our institution as a case of colitis, with the symptoms of recurrent vomiting, pain abdomen, and altered bowel habit, was eventually diagnosed to have Chilaiditi’s syndrome with non-specific colitis, after carefully taking the history and clinically examining the patient