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Background@#Retinoblastoma is the most common intraocular cancer in childhood in the Philippines. Most data though on demographics, clinical profile, treatment options, and outcomes in the country are from the National Capital Region. @*Objectives@#This study aimed to describe the demographics, clinical profile, treatment done, and outcomes of retinoblastoma patients seen in a public tertiary referral center in Davao from 2011-2020 to make available literature more representative of the status of retinoblastoma in the Philippines. @*Methods@#An analytical cross-sectional study was conducted using the records of retinoblastoma patients seen in a tertiary government hospital located in Davao Region from January 2011 to December 2020. @*Results@#There were 157 patients included in the analysis. Seventy-three (46%) were female with 44% coming from the Davao Region. One hundred seven (69%) patients had unilateral disease. Median age at initial consultation for patients with unilateral disease was significantly older than those with bilateral disease (p<0.003). Tumors were extraocular in 82 (40%) eyes. In the intraocular group, 36% of the eyes belonged to International Classification of Retinoblastoma (ICRB) Groups D and E. Enucleation was the most commonly performed treatment. Survival rate was 28%. This is the first report to provide epidemiologic and clinical data on retinoblastoma in the literature, including survival data, from Mindanao. Advanced stages and extraocular cases of retinoblastoma remain high. Delay of consultation contributed to the prognosis and clinical outcome of the disease.@*@#Conclusion. Advanced stages and extraocular cases of retinoblastoma remain significantly high in the country, even in Mindanao.
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Retinoblastoma , Therapeutics , Survival RateABSTRACT
Objective@#This study sought to define the profile and outcome of Covid-19 in adult patients with renal insufficiency admitted to the Bicol Regional Training and Teaching Hospital (BRTTH) from March 1, 2020, to February 28, 2021.@*Methods@#Retrospective cross-sectional study and utilized descriptive statistics.@*Results@#A total of 49 patients who tested positive for Covid- 19 also had renal insufficiency. The included patients were aged 51 to 60 (26.5%) and 61 to 70 (26.5%) years old, almost equal in sex distribution. Majority were unemployed (81.6%). On clinical profile most have no history of smoking (85.7%), alcohol intake (81.6%), and drug illicit use (100%). Predominantly the eGFR level was less than 15 mL/min (89.8%), with diabetes mellitus (36.7%) as the leading cause of renal insufficiency, followed by hypertension (61.2%). Majority received hemodialysis (81.6%) and advised for the continuation of hemodialysis (51%) upon discharge. Their length of stay was from 0-5 days (30.6%) with most being admitted to the intensive care unit (55.1%). Most were eventually discharged (63.3%).@*Conclusion@#Patients admitted in this hospital who had Covid-19 and renal insufficiency were between 51-70 years old, almost equally divided between males and females, and unemployed. Majority denied smoking, alcohol intake, and drug illicit use. The average eGFR was less than 15 mL/min, had diabetes mellitus and hypertension as a co-morbidity. The treatment received upon admission consisted mostly of hemodialysis only. Their length of hospital stay was 0-5 days with most being admitted to the ICU. Majority of the patients were eventually discharged.
Subject(s)
COVID-19 , Renal InsufficiencyABSTRACT
Introducción: La pandemia por COVID-19 es un problema de salud mundial. Habitualmente cursa con sintomatología leve y 5% de los afectados evoluciona a cuadros graves que requieren de cuidados intensivos. Objetivo: Determinar el perfil clínico, la mortalidad y factores asociados a la misma en pacientes con COVID-19 ingresados al Departamento de Cuidados Intensivos de Adultos, del Hospital de Clínicas de la Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Paraguay, entre agosto de 2020 a agosto de 2021. Pacientes y Método: Se realizó un estudio observacional analítico de corte transverso. Los datos se obtuvieron a partir de las historias clínicas de los pacientes. Resultados: Se incluyeron 214 pacientes críticos entre 21 y 85 años de edad (mediana 54 años), 57,9% del sexo masculino, 85% provenientes del Departamento Central y Asunción. La mortalidad global fue de 38,3%. Se asociaron significativamente con la mortalidad una edad ≥ 60 años, las comorbilidades (diabetes mellitus, cardiopatía, enfermedad renal crónica), los índices de gravedad (APACHE II, SOFA, inicial), procalcitonina elevada, utilización de vasopresor, asistencia respiratoria mecánica y utilización del decúbito prono; así como la presencia de SDRA y el requerimiento de depuración extrarenal. En el análisis multivariado (por regresión logística) los factores de riesgo de mortalidad independientes fueron: la edad mayor de 60 años, la utilización de noradrenalina y depuración extra-renal durante la hospitalización. Conclusión: Nuestra mortalidad es similar a la reportada internacionalmente. Los factores de riesgo de mortalidad identificados muestran una población con mayores posibilidades de un desenlace desfavorable.
Background: The COVID-19 pandemic is a world health issue. Generally, it is with mild and around 5% evolves to a severe disease that requires intensive care. Aim: To determine the clinical profile, mortality and associated factors in COVID-19 patients admitted at the Adult Intensive Care Department at the Hospital de Clinicas, between August 2020 and August 2021. Methods: Cross-section observational analytic study. Data was obtained from clinical charts. Results: 214 patients were included, with an average age of 54 years, 57.9% male. Overall mortality was 38.3%. Factors associated significantly with mortality were: ≥60 years of age, comorbidity (diabetes mellitus, heart disease, chronic renal disease), severity index (APACHE II, initial SOFA), high procalcitonin, use of vasopressor, mechanical respiratory assistance and prone decubitus; as well as the presence of acute respiratory distress syndrome and hemodialysis. Multi varied analysis identified as mortality risk factors: ≥60 years of age, noradrenaline use and hemodialysis. Conclusion: Mortality rate is similar to that reported worldwide. Mortality risk factors identified show a population with higher possibilities for unfavorable outcome.
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Background: Deficiency of factor VIII (FVIII) (Hemophilia A) and factor IX (Hemophilia B) are the most frequent coagulation defects. The incidence of hemophilia A varies in different regions of India. Aims and Objectives: The present study was done to classify hemophilia A patients by estimating FVIII levels in them and to describe the clinical profile of the patients attending a tertiary care hospital in southern part of India, Kerala. Materials and Methods: A hospital-based cross-sectional study was done on patients with hemophilia A, attending Department of Medicine and Department of Pediatrics from March 2012 to September 2013. Demographic and clinical details were collected using per forma and quantitative assessment of FVIII levels were done using semi-automated blood coagulation analyzer. Results: Out of 90 cases studied, majority of the patients had severe hemophilia (85.6%), followed by mild (10%) and moderate hemophilia (4.4%). Positive family history was seen in 67.8% patients. Median age of the patients at diagnosis was 1 years of age. Most common clinical presentation was found to be hemarthrosis (84.4%) followed by bleeding into muscle (56.7%). Knee joint (75.6%) was the predominantly affected joint. Bony ankylosis (30%), intracranial bleed (14.4%), and retroperitoneal bleed (24.4%) were the most common complications noted. Bleeding manifestations such as gum bleed (24.4%), epistaxis (12.2%), hematuria (37.8%), and ecchymosis (15.6%) were also reported among them. Conclusion: Proportion of severe hemophilia among hemophilia A patients was found to be higher in number than in other parts of the country. Serious complications can result from bleeding into the joints, muscles, brain, or other internal organs. Therefore, promotion of low cost, regular availability of factor concentrates, prophylactic factor replacement, establishing comprehensive care center, and regular training of medical and paramedical staff will help in reducing the complications due to this disease.
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Purpose: To describe the demographics, clinical profile, and outcomes of ocular siderosis in patients presenting to a multi?tier ophthalmology hospital network in India. Methods: This cross?sectional and hospital?based study included 3,082,727 new patients who presented between August 2010 and December 2021. Patients with a clinical diagnosis of ocular siderosis in at least one eye were included. Results: Overall, 58 eyes of 57 patients (0.002%) were diagnosed with ocular siderosis. The majority were men (96.49%) and had unilateral (98.25%) affliction. The most common age group at presentation was during the third decade of life with 24 patients (42.11%). A clear history of ocular trauma was documented in 47 patients (81.03%). Major clinical signs included corneal pigment deposition in nearly half of the eyes (27/58 eyes, 46.55%), corneal scar (20/58 eyes, 34.48%), cataract (22/58 eyes, 37.93%) and retinal detachment (11/58 eyes, 18.96%). The intraocular foreign body (IOFB) was anatomically localized in a majority of the eyes (i.e., 45/58 eyes, 77.59%). The most common location of the IOFB was in the posterior segment (22/58 eyes, 37.93%). The eyes that underwent a vitreoretinal surgery with removal of IOFB had a slightly better BCVA (1.0 ± 1.01) when compared to eyes with non?removal of IOFB (1.58 ± 1.00). Conclusion: Ocular siderosis is a rare sight?threatening entity, with half of the affected eyes exhibiting severe visual impairment. Majority of the eyes in ocular siderosis will have a detectable IOFB. Surgical removal of IOFB may lead to a better visual gain when compared to non?removal.
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Objectives@#In the Philippines, an estimated half million are affected annually by stroke. It is the third most common cause of mortality among Filipinos. Locally, there are limited data on the epidemiology of stroke in the country. This study aimed to study cerebrovascular disease in the rural setting in the country, primarily exploring the demographic characteristics, risk factors, clinical profile, and outcomes of patients assessed with cerebrovascular disease in the province of Sorsogon.@*Methods@#This was a retrospective study of all adult patients admitted to two tertiary hospitals in Sorsogon between February 1, 2020, and January 31, 2021, with a stroke diagnosis (International Classification of Diseases, Revision 10). A manual review of the charts and demographics, risk factors, clinical presentation, neuroimaging findings, and outcome were recorded.@*Results@#A total of 721 cases with a mean age of 63.06 ± 13.96 years were involved in the analysis. Of all the stroke cases, 64.7% were ischemic, and 29.7% were hemorrhagic strokes. The most common risk factors for stroke occurrence were hypertension (65%), history of stroke (16.2%), and diabetes (11.4%). Most sought consultation was due to one-sided weakness (41.3%) and slurring speech (14.2%).@*Conclusion@#In a third-class province in the Philippines, the most common type of stroke was an ischemic stroke. Analysis showed that diabetes was more associated with ischemia while hypertension was significantly associated with hemorrhagic stroke. A mortality rate of 26.8% was seen in this cerebrovascular disease population.
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Stroke , Risk Factors , Philippines , EpidemiologyABSTRACT
@#Spinal muscular atrophy (SMA) is the most common inherited lethal disease in children. Confirmatory diagnosis is based on molecular genetic testing of survival motor neuron (SMN) genes. We aimed to describe the phenotypic presentation of Filipino infants and children with SMA based on the copy number analysis of SMN genes. Medical records of 17 Filipino children were reviewed from January 2017 to December 2019. De-identified clinical data fulfilled the diagnostic criteria defined by the International SMA Consortium. Among Filipino children, the predominant SMA type by copy number was type I having two copies of SMN2 gene. The clinical severity based on symptom onset and highest functional motor capacity attained correlated with SMN2 copy number congruent with existing data. A significant time lag between symptom onset to confirmation of genetic diagnosis was noted. Nine out of the 17 (52%) children did not have a family history of the disease, raising the possibility of mutation carriers in these families since the incidence of de novo mutations in literature is about 2%. These data offered the first epidemiological pattern of genetically confirmed SMA among Filipino children; provided additional information for genetic counselling; and an avenue to consider pre-symptomatic newborn screening and carrier testing that would change proactive measures and opportunities for therapy. These measures unavoidably will decrease the incidence and prevalence of disease in the future.
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Muscular Atrophy, SpinalABSTRACT
Introduction@#Septic arthritis is an infection of the joint. Considered a medical emergency, it requires prompt diagnosis and treatment. Local data on the clinical profile of septic arthritis patients in the Philippines are still limited. Therefore, this study aims to determine the clinical characteristics and outcomes of patients with septic arthritis in the local setting.@*Objective@#To determine the clinical profile and outcome of adult Filipino patients with septic arthritis admitted at a tertiary hospital. @*Methodology@#This is a retrospective descriptive study of the medical records of patients with septic arthritis admitted at Chong Hua Hospital, Cebu City, from January 2012 to December 2019.@*Results@#Fifty- seven patients were included in this study. Sixty-four percent were males. Forty-three percent were between the ages of 45 to 64 years old. Diabetes mellitus (49.12%) was identified as the most common comorbidity. 94% of patients presented with monoarthritis, with the knee being the most commonly involved joint (73%). 85% of patients presented with joint pain and swelling. Gram-negative bacilli were the most common pathogen isolated at 31.5%. In addition, 87% of patients had synovial fluid white blood cell counts of more than 50,000/uL. Ceftriaxone was the most commonly used empiric antibiotic (31.5%). Based on sensitivity results, empiric antibiotic treatment was adequate in 66.67% of the cases. 64% of patients underwent surgical intervention in addition to antibiotic therapy.@*Conclusion@#This study highlights the unique characteristics of septic arthritis in this population, such as its prevalence in middle-aged patients and the isolation of gram-negative bacilli as the most common isolate. This study showed that the majority of patients were male, with monoarthritis as the most common presentation. Half of the studied population had diabetes mellitus. High clinical suspicion and awareness of risk factors should be emphasized so that timely and adequate treatment may be provided.
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Arthritis, InfectiousABSTRACT
Introduction@#The sociodemographic factors have a substantial impact on COVID 19 and understanding the characteristics and clinical presentation of COVID-19 is essential for diagnosis, management, prevention, and targeting clinical care and allocating resources.@*Objectives@#To determine the socio-clinical profile, hospital outcomes and predictors of mortality of patients with COVID19 in Perpetual Succour Hospital from March to September 2020.@*Study Design@#Retrospective observational study@*Materials and Methods@#The population consisted of 368 COVID 19 admitted patients in a tertiary hospital in Cebu City from March to September 2020. Data collection was done by reviewing the charts of the patients and analyzing for descriptive statistics.@*Results@#The COVID 19 patients were predominantly elderly males, smokers, with hypertension and diabetes. Smoking had a significant association with the mortalities. Cough, fever and dyspnea were the common manifestations. Intubated patients had a high mortality. Age, APACHE II and SOFA score, CRP level showed significant association with mortality. Acute kidney injury was the prevalent complication and respiratory failure was the primary cause of death. Majority of the admitted patients were classified as moderate and were discharged alive.@*Conclusion@#COVID 19 has a high recovery rate but poses a risk for the elderly, smokers and those with comorbidities. The manifestations mimic those of a respiratory infection and clinical parameters would usually be typical. Furthermore, acute kidney injury is common for infected patients, with respiratory failure and the need for intubation leading to increased morbidity and mortality.
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COVID-19 , MortalityABSTRACT
Background: Polycythaemia is defined as an increase in the hemoglobin above normal. This increase may be real or only apparent because of a decrease in plasma volume (spurious or relative polycythaemia) and the real polycythaemia can be because of primary due to genetic mutations or secondary due to increased erythropoietin production. The dominant symptoms from an increased red cell mass are related to hyper viscosity and thrombosis (both venous and arterial), because the blood viscosity increases logarithmically at hematocrits >55%. The present study aimed to characterize the different clinical presentations and to find out the complications associated with polycythaemia. Aim and objectives: To identify different clinical presentations of polycythaemia and to evaluate various etiologies of polycythaemia. Materials and methods: Patients with polycythaemia presented to OPD or in patient in the Department of General Medicine in Malllareddy Institute of Medical Sciences, Suraram from June 2020 to January 2022 were included. This was a descriptive observational study in which total of 24 patients were analyzed. Patients with polycythaemia (male Hb >16.5g/dl and females Hb>16.0g/dl) were included. Patients admitted with acute dehydration, sepsis and shock and other conditions leading to spurious polycythaemia and patient on diuretics were excluded. All the patients includedwho were found to have increased RBC mass not including patients from exclusion criteria. A detailed clinical history and physical examination was performed to identify clinical patterns of presentation and look for any complications, and necessary lab investigations were sent accordingly, to evaluate for the cause of polycythaemia. Results: A total of 24 patients were included in the study out of which 16 were males .and 8 were females. Polycythaemia Vera was found in 33% while secondary causes were seen in 67%, patients with polycythaemia vera were found to have more thrombotic complications and the mean age of presentation was in between 30- 40 years. Amongst the secondary causes COPD was the most common cause and smoking was the most common risk factor. Conclusion: Polycythaemia presents wide and varied clinical manifestations. polycythaemia rubra vera is a not an uncommon finding in patients presenting with symptoms of arterial or venous thrombosis, polycythaemia rubra vera is more commonly associated with thrombotic tendencies when compared to secondary causes of polycythaemia, when evaluating a case of polycythaemia it is necessary to look for signs and symptoms of secondary causes, to especially look for erythropoietin secreting tumors an high index clinical suspicion is required in such cases.
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Background: Acute respiratory illness with fever and respiratory symptoms such as cough and shortness of breath comprise the main clinical presenta?ons of Corona virus disease (COVID-19).Clinical manifesta?ons in COVID-19 shows significant regional varia?ons. Objec?ve of the study: To study the demographic and clinical profiles of laboratory confirmed COVID-19 pa?ents in South India Methods: In this cross sec?onal study,pa?ents diagnosed with COVID-19 by reverse transcriptase-polymerase chain reac?on (RT-PCR) test were taken up for the study.History of fever,throatpain,cough,breathlessness,malaise were taken.Blood pressure,respiratory rate,oxygen satura?on were recorded.Data on co-morbid illnessness like diabetes,hypertension,renal disease were also noted .All these were correlated to assess the clinical course of COVID-19 Results: Of the total 518 pa?ents,257(49.6%) pa?ents were in the age group of 46 to 65 years and 309 (59.7 %) pa?ents were males. History of fever was present in 349(67.38%) pa?ents and cough was present in 291 (56.17%) pa?ents. Throat pain and running nose was present in 291 (56.2%)and 110 (21.23%) pa?ents respec?vely. Heart rate was between 60 and 100 beats per minute in 472 (80.3%) of pa?ents and 102 (19.7%) pa?ents had respiratory distress with respiratory rate ?24. Oxygen satura?on was between 90-93% in 57 (9.85%) pa?ents and 87(16.8%) pa?ents were on oxygen support with 21(4.1%) pa?ents on non-invasive ven?la?on. A total of 291(56.2%) pa?ents were treated with steroids. Diabetes mellitus was present in 214(41.3%), hypertension in 150 (29%) pa?ents. Case fatality rate was 2.1% Conclusion: Severe disease and lower oxygen satura?on was associated with older age and co-morbid diseases par?cularly diabetes
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Background: Perinatal asphyxia and resultant hypoxic-ischemic encephalopathy (HIE) is not an uncommon phenomenon in a developing country, like Bangladesh. Electroencephalogram (EEG) is regarded as an effective prognostic tool. Correlation of clinical profiles and EEG findings of HIE patients arenot commonly observed in Bangladesh. The aim of the study was to observe the clinical profile and EEG changes in different stages of hypoxic-ischemic encephalopathy and compare them in a tertiary care hospital.Material & Methods:This is a cross-sectional observational study conducted for a period of six months in Dhaka Medical College Hospital, Dhaka. Sarnat and Sarnat score was used to classify HIE. 20 asphyxiated neonates without HIE were selected as the control group (group II) while 30asphyxiated neonates with HIE, were selected as the case group (group I) by purposive sampling. Clinical profiles, EEG findings, and immediate outcomes were observed and compared between the two groups.Results:73.3% patients were delivered at term and 30% patients were delivered at home in group I. 70% patients’ delivery were conducted by doctor in group I and 75% in group II. 63.3% patients had meconium stain in group I and 25% in group II, which was found significant. 46.7% had prolong labor in group I and 20% in group II, 40% had premature ruptured membrane (PROM) in group I and 40% in group II. Hypothermia, weak primitive reflexes, hypotonia, lethargy and seizure were significantly higher in group I. Changes in EEG correlated between the two groups and was found significant. Also, patients in group I, needed prolong hospital stay.Conclusions:The clinical profiles and EEG changes in patients with hypoxic ischemic encephalopathy was concluded that there is significant association with meconium stain, seizure, hypothermia, weak primitive reflexes, lethargic, miosis, hypotonia, poor APGAR score, burst suppression & SET findings in EEG and prolonged hospital stay in prenatal asphyxia with hypoxic ischemic encephalopathy.
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Background: Failure to seek early care and delays in hospital diagnosis are commonly acknowledged determinants of mortality in childhood pneumonia with a higher proportion specially in under developed countries like Bangladesh. Rather than detecting pneumonia by only signs, pulse oximetry may be a useful tool in ensuring the most efficient use of oxygen therapy, which is especially important in resource-limited settings. The aim of this study was to assess the relation between pulse oximetry and the clinical profile of children with pneumonia.Material & Methods:This cross-sectional type of descriptive study was conducted in Department of Pediatric, Rangpur Medical Collage and Hospital, Rangpur from July 2014 to June 2016. This study was carried out on 205 Children aged 2-59 months suffering from pneumonia inpatient and outpatient of Pediatric department.Results:It was observed that majority (91.7%) patients had cough184(89.8%) had breathing difficulty and 173(84.4%) patients had fast breathing. It was observed that majority (92.2%) patients had ability to cry while examined. Majority (90.7%) patients had crepitations. Three (1.5%) patients was found pallor of palms, 178 (86.8%) patients were heart rate ?100 beats per minute, 196(95.6%) were capillary refill time <3 second, 4(2.0%) hepatomegaly >2 cm and 131(63.9%) had temperature ? 38 °C. It was observed that Hypoxemia (?90%) was found 51(24.9%) of the patients. The mean SpO2 was found 88.6±4.7 percent with range from 70 to 99 percent.Conclusions:Cough, breathing difficulty and fast breathing are most common signs of children with pneumonia. Through pulse oximetry test, the prevalence of hypoxaemia was found in 24.9% children.
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Background: Three or more waves of COVID 19 pandemic have hit the different parts of world including India very hard, taking toll on the lives of people both in terms of morbidity and mortality. Keeping this in mind, the present study was conducted with an aim to determine the socio-demographic and clinical profile of laboratory confirmed COVID 19 cases and to determine their association with oxygen requirement and outcome of disease at the time of discharge. Methods: The present cross-sectional study was conducted on lab confirmed COVID 19 cases admitted in tertiary care hospital in Jammu from June-July 2021.Data was collected using convenient sampling method. The self-designed questionnaire used for data collection obtained information regarding socio-demographic characteristics of patients as well as clinical features of the disease. Results: Out of total 161 patients studied, 60.8% were males and 39.2% were females. Mean age was 51.2 ± 17.5 years. Comorbid conditions were present in 37.8% patients, with hypertension being the most common ( 36%). Cough, Fever, breathlessness and myalgia were the main presenting symptoms (90%, 81%, 57.7% and 56% respectively). The variables which were found to have statistically significant association with oxygen requirement and the outcome of disease at the time of discharge were age, gender and presence of co-morbidity (p <0.05). Conclusions: Advancing age, male gender and presence of underlying co-morbidity were found to be significant risk factors for the requirement of oxygen and poor outcome of the disease.
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ABSTRACT Background: A large number of patients admitted to the medical intensive care unit (MICU) have abnormal liver function tests (LFT). This includes patients with critical illness with or without preexisting liver disease and patients with acute primary liver injury. There are very few studies which have investigated the spectrum of liver disease, clinical profile and outcome in patients admitted to the MICU. Objective To evaluate the occurrence, etiology, clinical profile, laboratory profile and outcome of hepatic dysfunction in patients admitted to the MICU. To evaluate the utility of model for end-stage liver disease (MELD) score on admission as a predictor of adverse short term outcome in patients with hepatic dysfunction admitted in MICU. Methods: It was a prospective observational study, conducted from December 2017 to December 2018 in a tertiary care hospital. Two hundred and two patients admitted to the MICU with LFTs as per the inclusion criteria were analyzed and their short-term outcome at 7 days was studied in relation to various parameters. Results: LFT abnormalities were present in 202/1126 (17.9%) of the patients admitted to MICU. Critical illness associated liver dysfunction was found in 172 (85.2%) patients, chronic liver disease in 11 (5.4%) patients and acute viral hepatitis in 19 (9.4%) patients. Most common symptom was fever (68.3%) followed by vomiting (48.0%). Among LFT abnormalities, elevated transaminases, raised international normalized ratio and high MELD score on admission correlated with poor short-term outcome. Requirement for inotropes and mechanical ventilation correlated with poor short-term outcome. Mortality did not differ significantly between patients with chronic liver disease, patients with acute viral hepatitis and patients with critical illness associated hepatic dysfunction. Hepatic dysfunction in MICU was associated with poor outcome and a high short-term mortality of 56.4% (114/202). Conclusion: Liver function abnormality is common in patients who are admitted to the MICU and its presence is an indicator of poor short-term outcome.
RESUMO Contexto: Um grande número de pacientes internados na unidade de terapia intensiva (UTI) tem testes de função hepática anormais (TFH). Isso inclui pacientes com doença crítica com ou sem doença hepática pré-existente e pacientes com lesão hepática primária aguda. Há poucos estudos que têm investigado o espectro da doença hepática, perfil clínico e desfecho em pacientes admitidos em UTI. Objetivo Avaliar a ocorrência, etiologia, perfil clínico, perfil laboratorial e desfecho de disfunção hepática em pacientes internados na UTI médica. Avaliar a utilidade do modelo para doença hepática em estágio terminal (MELD). Escore na admissão como preditor de desfecho adverso a curto prazo em pacientes com disfunção hepática admitida em UTI. Métodos: Foi realizado um estudo observacional prospectivo, de dezembro de 2017 a dezembro de 2018 em um hospital de atenção terciária. Foram analisados 202 pacientes internados na UTI com TFH conforme os critérios de inclusão e seu desfecho a curto prazo de 7 dias foi estudado em relação a diversos parâmetros. Resultados: Anormalidades dos testes estiveram presentes em 202/1126 (17,9%) dos pacientes internados na UTI. Doença crítica associada à disfunção hepática foi encontrada em 172 (85,2%) pacientes, doença hepática crônica em 11 (5,4%) pacientes e hepatite viral aguda em 19 (9,4%) pacientes. O sintoma mais comum foi a febre (68,3%), seguido de vômito (48,0%) casos. Entre as anormalidades do TFH, transaminases elevadas, INR e escore MELD elevados na admissão correlacionaram-se com desfecho ruim de curto prazo. Exigência de inotrópicos e ventilação mecânica correlacionaram-se com desfecho de curto prazo ruim. A mortalidade não diferiu significativamente entre pacientes com doença hepática crônica, pacientes com hepatite viral aguda e pacientes com doença crítica associada à disfunção hepática. A disfunção hepática em UTI esteve associada a um desfecho ruim e à uma alta mortalidade a curto prazo de 114/202 (56,4%). Conclusão: A anormalidade da função hepática é comum em pacientes que são admitidos nas unidades de tratamento intensivo e sua presença é um indicador de desfecho de curto prazo ruim.
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Background: Head and Neck cancer (HNC) is a recognized major public health concern all over the world Objectives: To study age and gender predilection and clinical profile of Head & Neck Cancers Materials and Methods: This was a retrospective study including 21121 patients with Head & Neck Cancer presented to tertiary care centre, Ahmadabad. Patients' details of age, sex, site of carcinoma, stage at presentation and Outcome were recorded. The data was analyzed using MS office excel 2010 and Epi info software version 7.0. Result: Male to female ratio was 4.8:1. The most common site of presentation of tumour was in cheek mucosa (29.01 %). On comparison of different anatomical sites, majority of patients were presented in locally advanced stage. Significant association (p<0.05) was found between presentation of disease and literacy status. Overall 5 - year survival rate was 60.5% � 1.6% when disease was localized. Conclusion: Majority of patients diagnosed in locally advanced stage. Strategies for the early diagnosis and prevention of Head & Neck cancer must be undertaken by government to overcome this situation.
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Background: NAFLD is a condition defined by excessive fat accumulation in the form of triglycerides (steatosis) in the liver (> 5% of hepatocytes histologically). Non-alcoholic fatty liver disease is increasingly being recognized as a major cause of liver-related morbidity and mortality among 15-40% of the general population. Aim of the study: To evaluate the clinical profile of patients with non-alcoholic fatty liver disease and its association with metabolic syndrome.Methods:The present cross-sectional, retro-spective study was conducted as outdoor patient basis in the Department of Medicine, Jashore medical college hospital & a private diagnostic centre, Jashore.. A total of 74 cases were included for the study. All patients in the study underwent routine investigations including complete blood counts, blood sugar, liver function tests, HBsAg, anti-HCV, lipid profile andUSG of whole abdomen. The data was collected during OPD treatment and was recorded in predesigned and pretested proforma and analyzed.Results:Mean age of the patient was 53.70�22 years. On physical examination findings showed the mean BMI was 27.6�39 kg/m2, mean waist circumference was 74.22�44 cm. Mean diastolic blood pressure (mm Hg) was 92.87�25 and mean systolic blood pressure (mm Hg) 132.0�.17. Maximum 52% patients had triglycerides >150 mg/dl while low serum HDL level was seen in 37% patients and increased waist circumference was found in 32% patients. Altered ALT ?41 IU was observed in 10 (62.50%) of Grade II of patients with NAFLD with metabolic syndrome. Central obesity was observed in 12 (75.00%) of Grade II patients with NAFLD with metabolic syndrome. While 14 (87.50%) Grade II of patients with NAFLD with metabolic syndrome showed impaired fasting glucose (>110 mg/dl). Hypertriglyceridemia (>150 mg/dl) in 12 (70.58%) seen in Grade I of patients with NAFLD without metabolic syndrome.Conclusion:Higher prevalence of all the components of metabolic syndrome in cases of NAFLD was observed. It can be concluded that symptoms and signs of NAFLD are non-specific and occur later in the course of the disease hence the physician should have a high index of suspicion in order to detect NAFLD early in the course of the disease.
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Background:Seizure is defined as a paroxysmal event due to abnormal, excessive, hyper synchronized discharge from central nervous system neurons. A generalized tonic clonic seizure is involuntary movements of all limbs that have a tonic phase followed by clonic muscle c ontraction. It has various underlying etiologies.It is a major public health concern in terms of burden of disease,nature of illness, and its impact on individual, family, and community.Objective: This study was performed to evaluate clinical profile and MRI findings of patients admitted in LG Hospital with 1st episode of generalized tonic clonic seizures (GTCS).Design: The study was cross sectional study conducted over a period of 1yr in AMC MET medical college, Ahmedabad.Material And Methods:The clinical profile and MRI findings of 50 patients with 1st episode of GTCS admitted in the medicine department of our hospital were analysed. Result:The most common age group affected was 18-30 yrs (56%), more commonly affecting males (54%). The most common presenting symptoms are uprolling of eyes (90%), followed by frothing from mouth (80%) and tongue bite (78%). AmongMRI findings, the majority of patients (78%) had normal MRI followed by infarct (8%) and tuberculoma (4%). Conclusion:The onset of GTCS occurs most commonly in early adulthood and both male and female genders are almost equally affected. The most common presentation is tonic clonic type of convulsion with uprolling of eyes, frothing from mouth and tongue bite. Majority of patients didn't have any co-morbidities and also had normal laboratory parameters and normal MRI findings. In patients with metabolic precipitating factors; most common was alcohol withdrawal, while in those with CNS cause, the most common MRI finding was infarct.
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In Cameroon, the prevalence of deafness in children is 3.6%. The aim of this study was to describe the clinical profile of these hearing impaired children at the time of diagnosis. Patients and methods.This was a descriptive cross-sectional study that took place between November 2020 and June 2021 and involved 127 hearing impaired children. Results.The mean age of these children was 9.2 ± 3.9 years, with extreme values of 1 and 15 years. The sex ratio was 1.3. The average number of children in the siblings was 3.5 ± 1.8 children and 30.7% occupied the 1st rank in their siblings. The average birth weight was 3269 ± 0.685g. The neonatal history was found in 11.81% of the cases while the postnatal history related to 32.28% of the cases. Maternal alcoholism and parental genital infections were found during pregnancy. Familial deafness was found in one of the mothers (0.4%) and in the siblings in 3.1% (n=4). At the time of diagnosis, the median age was between 0 and 24 months, the mode of onset was old and 96.9% of children had bilateral deafness. The absence of reaction to noise and the delay of language were the most found modes of revelation. Moderate and severe deafness were the most represented and were mostly sensory or mixed. Among these deaf children, 4%presented a handicap or an associated pathology. Conclusion.The causes of child deafness in Yaoundé are acquired in perinatal period. This deafness is diagnosed in the perilingual period and remains dominated by bilateral deafness, whether severe or profound
Subject(s)
Child Health , Hearing Loss, Sudden , Aphasia , Pathology, Clinical , Health Profile , Prevalence , Health of the DisabledABSTRACT
@#<p><strong>BACKGROUND: </strong>There are numerous studies on adult patients admitted for COVID-19 but there is paucity of local data in children.</p><p><strong>OBJECTIVE: </strong>This study aims to determine the clinical presentation and outcome of children admitted for COVID-19.</p><p><strong>METHODOLOGY: </strong>This is a retrospective review of medical records of patients 0 to 18 years old with COVID-19 admitted in Philippine Children's Medical Center (PCMC). Descriptive statistics summarized the clinical profile of the patients. Pearson's Chi-Square and Fischer's Exact Test were used for data analysis.</p><p><strong>RESULTS: </strong>There were 100 confirmed COVID-19 pediatric patients admitted at PCMC from March 2020 to March 2021. Most were within the 0-4 years of age (52%). Fever (63%), respiratory symptoms (31%), and shock (28%) were the predominant clinical manifestations. Most (78%) had no exposure to symptomatic household contacts but all came from communities with known local transmission. Fourteen cases of hospital-acquired COVID-19 were also identified. Out of the 100 cases, 53 had critical COVID-19 on admission and 82 had co-morbidities, mostly neurologic, hematologic and infectious diseases. Seventy-four patients recovered and 26 patients died.</p><p>Fever (p-value=0.014) and shock (p-value=0.000), thrombocytopenia or thrombocytosis (p=0.030) and electrolyte imbalances (p=0.045) were significantly associated with critical COVID-19. There was no significant association between the presence of co-morbid conditions on admission and clinical outcome. O2 support by facemask (p=0.001) or by mechanical ventilator (p=0.001), and inotropic support (p=0.000) were significantly associated with mortality.</p><p><strong>CONCLUSION: </strong>Children admitted for COVID-19 infection generally recover but those with critical COVID-19 is highly associated with mortality.</p>