Clinico-epidemiological Profile Research Articles

CLINICO-EPIDEMIOLOGICAL PROFILE OF COVID-19 PATIENTS ADMITTED TO TERTIARY CARE MEDICAL COLLEGE HOSPITAL IN SOUTH INDIA

Objective: This is a retrospective study done in tertiary care medical college hospital in south India to look for clinico-epidemiological profile of coronavirus disease 2019 (COVID-19) patients admitted to the intensive care unit (ICU). This study can help us in identifying the risk factors leading to increased mortality. Hence, identifying these factors can help us in modifying the treatment depending on the risk factors that are present. Methods: All patients who are diagnosed with COVID-19 with reverse transcription polymerase chain reaction positivity admitted to ICU are enrolled. Data are collected retrospectively by analyzing the medical case records and looking for all parameters, such as age, sex, underlying comorbidity, method of oxygen therapy, degree of severity, and inflammatory markers. All these data are analyzed and compared between survivors and non-survivors. Results: 81% were male patients in comparison to female patients contributing to 19%. 55% were <60 years and 45% were >60 years. Non-survivors had a mean age of 64.5 years. Average days of hospital admission, ICU admission, and onset of hypoxia after symptom onset were 4.2 days, 8.5 days, and 7.8 days, respectively. Average PaO2 and P/F ratio was 81.25 and 165.9, respectively. The average P/F ratio in non-survivors was 144 compared to survivors having 187. The average high-resolution computed tomography score on admission and discharge was 12.4 and 11.9, respectively. Regarding inflammatory markers average lactate dehydrogenase (LDH), Ferritin, and interleukin-6 were 462, 618.2, and 130.56, respectively. Non-survivors had increased LDH with a mean of 538.3 when compared to survivors having a mean of 421.4. Conclusion: This study showed that there is increased mortality with an increase in age, especially >60 years. Severe respiratory failure with P/F ratio<144 had increased mortality. Patients with increased LDH showed an increase in mortality.

Clinico-epidemiological Profile of Frostbite Cases in High Altitude Region of Northern India

Abstract Objectives: The objective of the study was to study the clinico-epidemiological profile of frostbite cases in high altitude region of Northern India. Study Design: This study involves a descriptive study. Materials and Methods: A descriptive study was undertaken in service hospitals situated in the northernmost region of India receiving frostbite cases from December 1, 2019, to Mar 30, 2020, to assess their clinico-epidemiological profile. A semi-structured questionnaire was designed comprising demographic characteristics and clinical and epidemiological characteristics of the frostbite cases. Frostbite cases were classified based on grades of injury and were studied for any association with age, physical activity, and temperature extremes. Results: A total of 29 cases of frostbite were reported during the study period with the majority of cases being <25 years of age. All cases were reported at altitudes of above 12,000 ft. and maximum cases gave a history of direct exposure to extreme weather conditions or other predisposing factors. The most common complaint at the onset of the symptoms was discoloration of the skin followed by swelling of digits and pain with most of the cases falling under first and second grade of injury. Protective clothing and footwear were adequate during induction/de-induction/stay in extreme climate regions. Conclusions: Exposure to extreme cold climates, high altitude, personal clothing, and physical exertion plays an essential role in the occurrence of frostbite cases as well as their severity. With the rising number of cases of frostbite, understanding of multiple factors which predisposes to frostbite injury is essential.

Clinico-Epidemiological Profile and Outcome of Acute Poisoning Patients admitted to Intensive Care Unit in A Tertiary Level Private Hospital in Bangladesh

Background: Acute poisoning is a prevalent health issue necessitating Intensive Care Unit (ICU) admission in developing countries. This study evaluates the socio-demographic characteristics, clinical parameters, and outcomes of acute poisoning patients admitted to the ICU in a tertiary level private hospital in Bangladesh. Method: This retrospective cohort study was conducted at tertiary care private hospital in Narayanganj, Bangladesh. Data was collected from ICU medical records from January 2023 to April 2024, enrolling a total of 57 patients aged 18 years or more who presented with acute poisoning. Data analysis was performed using Stata (Statistical Software for Data Science) 17.0(p < 0.05) Results: Out of 57 patients, 52.63% were females, with mean age of 27.84 years. Suicidal intent accounted for 84.21% of cases, and the primary reasons for poisoning included marital (61.40%) and familial disharmony (15.79%). The predominant type of poisoning was due to sedatives (17.54%) followed by aluminium phosphide (14.04%), and stupefying agents (14.04%). Aluminium phosphide poisoning had a 100% fatality rate, while sedatives and several other agents had 100% recovery rate. Statistical analysis showed a significant association between the type of poison and the final outcome (χ2(15) = 38.7996, p = 0.001). Conclusion: The study highlights the prevalence of intentional poisoning among young adults, especially females, with sedatives, aluminium phosphide, and stupefying agents being the most common. The high mortality rate from aluminium phosphide underscores the need for strict regulations and public awareness to control access to these substances. Bangladesh Crit Care J September 2024; 12 (2): 89-95

Clinico-Epidemiological Profile and Treatment Outcome of Small Cell Lung Carcinoma: A Retrospective Study from a Tertiary Cancer Centre in Northeast India

Background: Small cell lung cancer (SCLC) accounts for 12-15% of all lung cancers and is associated with poor outcomes. This study aimed to understand the clinico-epidemiological profile and outcomes of SCLC in the North-East Indian population. Methods: A retrospective analysis was performed on medical records of patients with SCLC who were diagnosed, treated, and followed up at the Department of Medical Oncology, Dr. B. Borooah Cancer Institute, during the period from January 2016 to December 2021. Results: A total of 70 patients were evaluated, with a median age of 62 years, and 82.8% were male. The majority of patients (72.8%) were diagnosed with extensive-stage (ES) disease. Common symptoms included cough (61.4%), chest pain (45.7%), and breathing difficulty (44.2%). The most commonly used chemotherapy regimen was etoposide-platinum. Overall survival (OS) for all patients was 6.1 months. Three-year OS was significantly better in patients with limited-stage (LS) disease (16.4 months vs. 4.3 months in LS vs. ES disease, p<0.05). Median progression-free survival (mPFS) for all patients was 4 months. Survival rates at 6, 12, 24, and 36 months were 45.7%, 18.5%, 5.7%, and 1.4%, respectively. Median OS was significantly correlated with the number of metastatic sites (8.6 months with <3 organ involvement vs. 1.9 months with ≥3 organ involvement; p<0.0001). Patients who received combined modality treatment had better survival than those treated with chemotherapy alone (10.7 months in chemo-radiotherapy vs. 3 months in chemotherapy alone, p<0.001). Conclusion: SCLC remains a highly aggressive disease with poor survival. Advanced-stage presentation with distant organ metastasis is the most important factor associated with poor survival in patients with SCLC1

Clinico-epidemiological profile of dermatology patients: a one-year study at a newly established tertiary care centre in India

Background: Dermatology is predominantly an outpatient specialty focused on the diagnosis and treatment of dermatoses affecting the skin. We conducted a study on the demographic and clinical characteristics of patients attending the outpatient clinic to better understand the clinico-epidemiological profile and to predict morbidity patterns within the specific geographical region. Methods: A retrospective study was conducted over the past year, encompassing all patients who visited the outpatient dermatology clinic at AIIMS, Raebareli. The study systematically documented a range of dermatoses, including disorders affecting the skin, hair, and nails. Results: A total of 4,188 patients were included in the study, comprising 2,681 (64%) adults, 978 (23.4%) geriatric patients, and 529 (12.6%) pediatric patients. Among these, 1,311 patients primarily suffered from infections, followed by 752 patients with dermatitis. Of those with infections, 1,024 (78%) were diagnosed with fungal infections, while scabies was observed in 126 patients (9.6%). In the adult group, 756 (28.2%) patients had infections, while 429 (16%) patients were affected by dermatitis. Similar patterns were observed in both the geriatric and pediatric groups, with infections being the most prevalent, affecting 214 and 341 patients, respectively. Conclusions: Based on the findings of this study, it can be concluded that infections, particularly fungal infections, are the most prevalent dermatological conditions across all age groups in the population studied. Dermatitis also emerged as a significant concern, particularly among adult patients. The high prevalence of infectious dermatoses, especially in geriatric and pediatric patients, highlights the need for targeted public health interventions and preventive measures.

Clinico-epidemiological profile & outcome of patients presenting with cerebral venous thrombosis to emergency department

ObjectivesTo better understand the clinical and radiological characteristics of Cerebral Venous Thrombosis (CVT), we conducted a study focusing on the assessment of neurological outcomes and factors associated with poor prognosis in patients with CVT. MethodsThis prospective, observational study took place over two years (July 2020 to June 2022) in a tertiary care teaching hospital in South India, encompassing adults aged 18 years and over. Key data points included demographic information, symptomatology, physical and neurological examinations, neuroimaging findings, hospital interventions, and neurological outcomes at discharge and at a six-week telephonic follow-up. ResultsA total of 140 patients with CVT, median age 34 years, were studied. 61.4 % were males. The most common symptoms and signs were headaches (70.7 %) and papilledema (60.7 %). Hemorrhagic infarct was the most prevalent finding on the non-contrast computed tomography (NCCT) of the brain, involving 39.4 % of patients. The most commonly affected sinus was the superior sagittal sinus. Risk factors most often observed were alcoholism (45 %), smoking (21.4 %), anemia (27.1 %), oral contraceptive pill usage (12.1 %), and hypertension (12.1 %). Deep vein thrombosis or pulmonary embolism was present in 5 % of the patients. The mean hospital stay was 13.9 days, with 6.4 % of patients requiring endotracheal intubation at presentation and 22.9 % during their stay. The observed in-hospital mortality rate was 17.9 %, increasing to 22.4 % at the six-week follow-up. Morbidity (mRS 3–5) was 24.3 % at discharge, decreasing to 8.2 % at six-week follow-up. Favorable outcomes were reported in 57.9 % of cases at discharge, rising to 69.4 % at six weeks. ConclusionsOur study underscores the importance of recognizing cardinal symptoms and diverse risk factors of CVT, including alcoholism and anemia. Majority of CVT occurrences were observed in males aged 18–29. Critical determinants of heightened morbidity and mortality were identified, including lower GCS scores and the necessity for advanced interventions. Notably, majority of patients presented favorable neurological outcomes at six-week follow-up.

Clinicoepidemiological Profile of Retinopathy of Prematurity.

Purpose In previously performed studies, retinopathy of prematurity (ROP) has been shown to occur postpartum. As a result, mechanical ventilation and oxygen dependence were eventually connected to the development of ROP in these preterm children, and ROP prevalence is on the rise globally. Despite various improvements in childcare, ROP still tends to arise due to various risk factors associated with the disease. So, clinically the research was performed to determine the clinical and epidemiological profile of ROP. Materials and methods A total of 268 participants were to be enrolled in the study. It was an observational, cross-sectional study carried out at Department of Ophthalmology and Neonatal Intensive Care Unit in Veer Surendra Sai Institute of Medical Sciences and Research Centre, Burla, Sambalpur, Odisha, India. Ethical approval was provided on 30 November 2019. Results Overall 123 (46%) infants out of 268 infants developed retinopathy of prematurity. Majorly, the infants had stage 1 and stage 2 ROP. Most of the infants were male. Birth weight in ROP patients was 1000 g or less in 54% of infants, 1000-1500 g in 46% of infants and >1500 g in 33% of infants. Gestational age was found to be a predictor of retinopathy of prematurity. The adverse events that were found to be associated with retinopathy of prematurity were sepsis (53%), respiratory distress syndrome (RDS) (54.6%), intraventricular haemorrhage (IVH) (60%), anaemia (61.5%). Conclusion It has been observed that babies with higher birth weights and older gestations are also susceptible to developing ROP. Therefore, the greater birth weight newborns up to 1750 g and older gestational age babies >34 weeks should also be included in the screening criteria, especially if they have risk factors such as oxygen supplementation, sepsis, RDS, and anaemia.

Clinico-Epidemiological Profile of Children Admitted with Pericardial Effusion in a Tertiary Care Hospital: An Observational Study.

Pericardial effusion is rare in children, and the diagnosis is often delayed due to varied presentation and lack of classical Beck's triad manifestation. Delayed initiation of management leads to high mortality (30%). This study aimed to identify the clinico-epidemiological profile of children with pericardial effusion and their outcome. This retrospective study was conducted at the pediatric intensive care unit of a tertiary care center in northern India from January 2019-September 2021, and included children (1 month-18 years) with pericardial effusion. History, clinical presentation, examinations, radiological and laboratory investigations were analyzed. Fifty-four children [median age 63 months (46.5, 132)] were included. Of these children, 78% had at least one feature of Beck's triad; muffling was predominant (42.6%). Overall, 35.2% had severe effusion. The incidence rates of tamponade (66.7%), muffling (68.4%), cardiomegaly (100%), and low voltage electrocardiography (100%) were higher in those with severe effusion compared to those without severe effusion (48.4%, 42.6%, 83.3%, 59.3% respectively). Overall, 44.4% of the children underwent pericardiocentesis, and 9.3% had pigtail catheterization. The children requiring pigtail catheter insertion underwent the procedure within 24 hours of admission. Pericardial effusion of tubercular etiology (19/54) mainly presented with breathlessness (84.2%), poor appetite (63.1%), and weight loss (42.9%), and the incidence rates of severe effusion and pericardiocentesis were 52.6% and 68.4%, respectively. Overall, the mean duration of pigtail catheter in situ was 11.4 days (±6.05), including 8.66 days (±3.77) in the non-tubercular group and 15.5 days (±6.5) in the tubercular group (p = 0.33). Most of the children with pericardial effusion in this study had tubercular etiology, and most had a severe presentation and required pericardiocentesis. Early suspicion, even the presence of a single component of Beck's triad, may be helpful for prompt management.

Clinico-epidemiological Profile of Primary Hyperhidrosis in Indian Patients: Single-center Experience

Abstract Background: Primary hyperhidrosis (PHH) is characterized by excessive sweating which is focal, bilaterally symmetrical, idiopathic with age of onset before 25 years of age. The QoL derangement comparable to chronic disorder like psoriasis. There exist a scarce data about prevalence, facto associated with PHH and its correlations with hyperhidrosis disease severity score (HDSS) and dermatology life quality index (DLQI) in Indian population. This study aimed to bridge this gap. Aim and Objectives: The aim of this study is to understand the features associated with PHH and to describe distribution of known etiologic factors of hyperhidrosis in individuals visiting the Dermatology OPD. Also this study assess the impact of excessive sweating on the QOL. Material and Methods: The study design is prospective observational study in patients visiting Dermatology OPD at tertiary care hospital. The study was questionnaire based and for appropriate case multispecialty referral and necessary investigation to rule out secondary cause was done. The study period was of total 18 months from Dec 2016 to May 2018. Data collected was analyzed by SPSS V 23. Results: In our study the male predominated with M: F ratio of 1.4 :1. Total 42,365 patients visited to dermatology OPD in this time frame and prevalence was found to be 2.6%. The mean age at presentation in our study was 24.5 years, with mean age of onset being 15.33 years (90% before third decade). Family history was present in 52.6% patients. Most common site affected was palmoplantar (43.8%) followed by palmar (36.3%). DLQI score was more in students as compared to salaried individuals or housewife similarly the palmoplantar HH patients has more DLQI score as compared to other site affected patients. Similar finding was applicable for HDSS scale. Conclusion: The PHH is underreported entity with prevalences of approx. 2.6% in our study. The impact on QOL is very profound and it is positively correlated with HDSS. There is felt need to carry targeted data collection for PHH.

Trends in Clinico-Epidemiological Profile and Outcomes of Patients with HIV-Associated Cryptococcal Meningitis in Shanghai, China, 2013-2023.

The study aimed to analyze changes in the clinical and epidemiological aspects of HIV-associated cryptococcal meningitis (CM) patients and to identify factors influencing their prognosis. Clinical data of patients with HIV-associated CM treated in Shanghai, China between 2013 and 2023 were collected. This study included 279 cases, 2.89% of AIDS patients, showing a yearly decrease in CM prevalence among AIDS patients (p < 0.001). Overall mortality was 10.39% with rates declining from a 2013 peak of 15.38% to 0% in 2023 despite no significant temporal pattern (p = 0.265). Diagnosis took an average of 18 ± 1 days post-symptoms, and admission CD4 counts averaged 29.2 ± 2.5 cells/μL, hinting at a non-significant decline. Frequent symptoms included fever (62.4%), headache (61.6%), fatigue (44.1%), and appetite loss (39.8%), with younger patients more likely to initially show signs of meningeal irritation. Logistic regression analysis underscored the prognostic importance of cerebrospinal fluid (CSF) white blood cell (WBC) count and procalcitonin levels. Over the decade spanning from 2013 to 2023, the incidence and mortality rates of CM among AIDS patients exhibited a downward trend. The average duration from the onset of CM to confirmation of diagnosis remained prolonged. CSF WBC count and procalcitonin levels were associated with unfavorable outcomes.

Some concerns on 'clinico-epidemiological profile and outcome of snakebite patients presented to a teaching institute - A descriptive retrospective review'.

Some concerns on 'clinico-epidemiological profile and outcome of snakebite patients presented to a teaching institute - A descriptive retrospective review'.

Clinico-epidemiological profile of skin cancer in South Western Nigeria

Clinico-epidemiological profile of skin cancer in South Western Nigeria

Clinico-Epidemiologic Profile and Response to Levocetirizine in Chronic Spontaneous Urticaria: A Retrospective Cohort Study from a Tertiary Care Center in North India.

Comprehensive long-term follow-up data regarding chronic spontaneous urticaria (CSU) among general populations, especially from the Indian subcontinent is scanty. The aim of the study were to analyze the clinico-epidemiological profile, comorbidities of CSU patients, and factors affecting patient response to various doses of levocetirizine. In this retrospective cohort study, complete history regarding demographic profile, clinical examination, investigations, treatment given, and follow-up details of all CSU patients attending urticaria clinic between 2010 and 2019 were analyzed. These were considered variables to determine the factors playing a role in response to various doses of levocetirizine. Totally, 1104 files of CSU were analyzed. The male-to-female ratio was 1:1.5 with a mean age of 33.03 ± 14.33 years. Thyroid dysfunction and atopy were seen in 142 (12.8%) and 184 (16.7%) patients, respectively. Vitamin D deficiency and high serum immunoglobulin E (IgE) levels were seen in 461 (41.7%) and 340 (30.7%) patients, respectively. Immunosuppressives were required at some point in 196 (17.7%) patients. Patients with higher levels of serum IgE and D-dimer (P < 0.05) were found to require frequent updosing of levocetirizine, while age, sex, duration of illness, presence of angioedema, co-morbidities, identifiable precipitating factors, presence of diurnal variation, family history, and vitamin D deficiency were found to not have an effect on levocetirizine dosing. Ours is a large single-center study exemplifying the biomarkers including baseline serum IgE and D-dimer levels, which could identify a CSU patient who could warrant a higher dose of antihistamine/antihistamine refractory urticaria.

Clinicoepidemiological profile of measles in adults: A study from semi-urban area in South India

BackgroundMeasles is a highly contagious, airborne disease caused by rubeola virus of paramyxoviridae family. It presents with fever, rash, and other associated symptoms like headache, cough, coryza, and conjunctivitis. It is common in children, and when occurs in adults, it is usually morbid. The clinical data on adults’ measles in Indian scenario are sparse. We report here an outbreak of measles affecting 52 adults. The primary objective of the study was to describe the clinical and laboratory findings obtained in an outbreak of adult measles cases from semi-urban area in India. MethodsThe study was an observational study conducted in a secondary care health center over a period of 2 months. ResultsFifty-two males with median age of 22.02 ± 3.5yr were diagnosed and treated for measles. All presented with fever and rash. The characteristic Koplik's spots appeared in 21 cases. On the day of their admission, 48% had lymphopenia and only one had thrombocytopenia. Liver enzyme dearrangements were seen in 18 patients. Sixteen patients had complications which included eight pneumonitis, three corneal ulcerations, three otitis media, and one case of acute encephalitis and polyserositis each. No deaths were reported in our study. We followed 34 cases and observed that their rashes healed with scars and laboratory parameters got normalized after six weeks. ConclusionClinician should be vigilant of measles as a differential in adults presenting as fever with rash. In doubt, the serological sampling should be carried out. Mass immunization is necessary to prevent the outbreaks.

Clinico-epidemiological profile of children presenting with enuresis

Clinico-epidemiological profile of children presenting with enuresis

A Retrospective Study to Assess the Clinico-Epidemiological Profile of Acute Poisoning Patients Admitted in a Tertiary Care Hospital, Karnataka, India

ABSTRACT Background and Objectives: Acute poisoning is one of the most common medical conditions which requires emergency management. This study was aimed to generate the clinico-epidemiological profile of acute poisoned patients admitted to the emergency department in a tertiary care hospital. Methods: A retrospective research study was conducted in between June 2018 and September 2019. All acute poisoned patients admitted in KH hospital Manipal were included in the study. Collected data were analyzed using descriptive and inferential statistics. The obtained results were stated as frequency, percentage, and Chi-square analysis. Results: Among 324 poisoned patients, 47.5% were organophosphate poisoning, with 48.9% belonging to the age group of 19–35 years. Apparently, 59.2% were male patients. The most common route of poisoning seen is 96.60% ingestion. Suicidal poisoning was noted in majority of the patients 92.90%. A large number of poisoned patients, 61.11%, were conscious while reporting to emergency department. The main reason for poisoning was marital disharmony 54.32%, and 14.5% patients were put on ventilator life support during treatment. Recovered and discharged from the hospital was seen in 76.54% of patients and death witnessed in 12.34% of poisoned patients. The patient outcome was found to be significantly associated with type of poisoning (P &lt; 0.001) and motive of poison consumption (P &lt; 0.001). Conclusion: This study has succeeded to contribute added evidence concerning the clinico-epidemiological profile and consequence of acute poisoning patients admitted in a tertiary care hospital. Increased treatment expenses and admission in intensive care make burden to the family.

Clinico-epidemiological and Patch Test Profile of Patients with Suspected Allergic Contact Dermatitis to Cosmetics in a Tertiary Care Hospital in the Southern Philippines: A 3-year Retrospective Study

Background: Allergic contact dermatitis (ACD) is a common skin inflammatory reaction occurring at the site of challenge with a contact allergen in sensitized individuals and one of the most common causes for consultation in dermatology clinics. Patch testing is a method for detecting the causative component in suspected cases of ACD. Awareness about the causative allergen aids in reducing morbidity and can significantly minimize the impact of ACD in the affected people. Objectives: The study aimed to measure the number of relevant positive reactions in patch tests being performed in our institution in patients with ACD to cosmetic products. Methods: A total of 60 patients who were diagnosed with ACD to cosmetics and underwent patch testing were reviewed to identify the clinico-epidemiological and patch test profiles of these patients. Results: The study showed that the mean age of patients was 42 comprising mostly of females. Most of the patients were unemployed, office workers, and medical workers. The most common cosmetic products that caused ACD include soaps, shampoos, lotions, and moisturizers. Nickel is still the most tested positive among these patients, followed by fragrance mixes and 4-phenylenediamine base. They are widely distributed in cosmetic products, especially in soaps and lotions. The pattern of dermatitis revealed facial dermatitis to be the most common reason for consult of these patients. Conclusion: Patch test is valuable in the setting of establishing the etiology of ACD to cosmetic products.

Clinico-Epidemiological Profile of Vitiligo Among Patients Attending a Tertiary Care Centre of North-East India.

Objectives Vitiligo is a widespread cutaneous disorder. The present study aims to evaluate the epidemiologic profile of vitiligo and investigate its different clinical forms, disease activity, hereditary associations, triggering factors, and probable association with other diseases. Methods This prospective observational study was conducted over one year, from 2019 to 2020, and included 120 cases demonstrating definite clinical evidence of vitiligo. All selected patients underwent a detailed medical history interview. Specific enquiries were made regarding precipitating factors, clinical features of the disease, histories of other autoimmune diseases, and family histories. Thorough clinical, laboratory, and cutaneous examinations were performed on all patients. Descriptive statistical methods and diagrams were used to summarise the data. Results The age at presentation (31 patients, 25.8%) and the onset of the disease (32 patients, 26.6%) was predominantly in the second decade of life. The condition was usually progressive, with vitiligo vulgaris being the most prevalent type (56 cases, 46.7%). Disease onset (37 individuals, 30.8%) and the prevalence of lesions were higher in the lower leg. Body surface area involvement was ≤1% in 72 (60.0%) patients. Itching and trauma were the typical initiating factors. Leukotrichia in 38 (31.7%) cases, Koebner's phenomena in 23 (19.1%) cases, and a positive family history in 26 (21.7%) cases were observed. Thyroid dysfunction, hypertension, and various skin conditions are associated with the disease. Conclusion Vitiligo is more common in the young population. The condition is often progressive, with vitiligo vulgaris being the most common type. Itching and trauma are frequent initiating factors. Monitoring patients for associated diseases may be crucial for diagnosis and treatment outcomes.

Clinico-Epidemiological Profile, Trends, and Health-Related Outcomes of Snakebite Victims: A One-Year Prospective Study from Eastern India.

Snakebite envenomation is a significant life-threatening public health problem in Southeast Asia (SEA). In this region, India reported the largest number of snakebite deaths from 2000 to 2019 (1.2 million), with an average of 58,000 deaths yearly. This prospective observational study was carried out among snakebite victims at the emergency department (ED) of a tertiary care public sector hospital in eastern India. A total of 145 cases of venomous snakebite were investigated. More than half (n = 81, 56%) of the snakebite victims were between 17 to 45 years. Most of the snakebite victims were male (68%) and were farmers (53%) by occupation. The majority of snakebites occurred during the daytime (76%) and while outdoors (67%). Most victims sustained a bite on the lower extremity (71%). The peak incidence of snakebites occurred from June to September (69%). Three-quarters of all patients were unaware of the required first aid measures following a snakebite. Among the 145 venomous snakebites, 48 were presumptively identified as the Indian cobra, 32 by the Indian krait, 56 by the Russel's viper, and 9 by saw-scaled viper. The mean duration from the snakebite to the onset of systemic effects in the Indian cobra was 52 ± 14.28 min, 66 ± 18.35 min in the Indian krait, 42 ± 13.47 min in Russel's viper, and 48 ± 16.38 min in saw-scaled viper. Respiratory failure was the commonly observed complication following an elapid envenomation. The mortality rate was 2.1% among the patients treated with antivenom. Snakebite is considered an occupational hazard in India, commonly affecting the young population in their productive period. The peak incidence was during monsoon season, and the majority had neurotoxic envenomation following an elapid bite (55%) that contributed to the increased mortality and morbidity among young adults. Of the 145 patients, the majority (84%) recovered fully with treatment; 16% of the victims developed morbidity viz cellulitis, respiratory failure, acute renal failure, compartment syndrome, local tissue necrosis, intracerebral hemorrhage, and disseminated intravascular coagulation. Appropriate first aid measures and timely medical intervention can significantly improve the treatment outcome following snakebites.

Retrospective Analysis of Clinico-Epidemiological Profile of COVID 19 Associated Mucormycosis Patients: A Single Centre Experience in Southern Haryana

Background: A number of factors were supposed to be involved in very high rate of mucormycosis infectionin COVID 19 patients like the reduced immunity because of COVID infection itself along with use of steroids,administration of supplemental oxygen, worsening glycemic control. This retrospective study has been undertaken to analyse the clinical and demographic profile of patients and various other factors that were involved in development of mucormycosis.Material and Methods: This was retrospective observational study in which all patients admitted were eithersuspected but came out to be negative or which were culture or histopathological proven mucormycosis cases.The data was analysed for demographic as well as clinical profile of the patients and various risk factors involved.Results: Total 52 patients were included in the study. All of these were rhinoorbitocerebral mucormycosis patients.The mean age of mucor positive patients was 47.3 years with male to female ratio as 5:1. The comparison of risk factors among mucor positive and mucor negative patients showed that out of 30 mucor positive patients there were 18 (60%) patients with confirmed report of COVID 19 infection, 22 (73.3%) diabetic patients, 17 (56.7%)patients with recent history of steroid treatment and 11 (36.7%) patients with history of recent oxygen therapy.Conclusion: In this study there was no statistically significant association between specific risk factors and mucorpositivity, emphasizing the multifactorial nature of mucormycosis. Further research is necessary to evaluate the complex relationship between COVID-19 infection and other factors in the development of mucormycosis.