Record-based Study Research Articles

ACUTE INFECTIVE CONJUNCTIVITIS A RETROSPECTIVE STUDY OF THE RECENT OUTBREAK REPORTED IN TERTIARY CARE CENTRE

Objective: Acute conjunctivitis refers to the inflammation of conjunctiva, mostly of viral etiology and is highly contagious and self-limiting. The present study aims to assess the clinical characteristics, presentation, outcomes of acute conjuctivitis and its treatment for complications among the study population. Methods: It was a record-based retrospective study conducted in a tertiary care teaching hospital in Puducherry for the period of two months among 100 study participants. Results: The study showed that 62% and 16% of patients had complications like membrane formation and Superficial Punctate Keratitis (SPK). Moxifloxacin was highly used antibiotics (57%), with the median duration of the treatment being six days (IQR: 5 – 7.75). Conclusion: From our study, we found that even though the conjunctivitis outbreak is widespread among the general population due to its contagious nature and is self-limiting, it requires medical attention to prevent complications. Public awareness is required regarding this

Epidemiological Evaluation of Suicidal Deaths due to Hanging: A Retrospective Medicolegal Study in Sylhet

Background: Suicidal hanging is the most common method of suicide in developing countries, especially among young people. During conventional autopsies, it is one of the significant causes of unnatural deaths in Bangladesh. This study was performed to determine the epidemiological evaluation of suicidal deaths due to suicidal hanging at the mortuary of the Forensic Medicine Department of Sylhet MAG Osmani Medical College, Sylhet. Materials and methods: An autopsy record-based retrospective study carried out to ascertain the epidemiological evaluation of 340 cases of suicidal hanging deaths from January 2015 to December 2018 in the Department of Forensic Medicine, Sylhet MAG Osmani Medical College, Sylhet. Results: Hanging was more common in the age ranges of 10-19 years (33.0%) and 20-29 years (29.1%), accounting for nearly two-thirds (62.1%) of all deaths. The incidence was higher in females (59.3%) than males (46.7%). Gowainghat (12.1%) and Kotwali (9.5%) had the highest incidences of victims. The most common autopsy findings were that the subcutaneous tissues underneath the ligature mark were found to be pale, white, hard and glistening in 94.2% of cases, cyanosis was found in 89.8% of cases, dribbling of saliva was seen in 66.3% of cases and subconjunctival petechial haemorrhage was observed in 46.0% of cases. Asphyxia (93.3%) was the most common cause of suicidal hanging deaths identified during autopsy. Conclusion: The majority of victims were female and young individuals were especially vulnerable to suicidal ideation, attempts and suicide by hanging. To reduce suicides, awareness programs, psychological counseling andsuicidal behavioral treatment are recommended. IAHS Medical Journal Vol 7(1), June 2024; 13-16

Differences in the Relationship Between Educational Attainment and Health Status Across Racial and Ethnic Groups in a Multi-ethnic United States Older Adult Population: A Cross-Sectional Electronic Health Record-Based Study

Differences in the Relationship Between Educational Attainment and Health Status Across Racial and Ethnic Groups in a Multi-ethnic United States Older Adult Population: A Cross-Sectional Electronic Health Record-Based Study

Adverse Events Following Equine Rabies Immunoglobulin Administration among Category 3 Animal Bite Exposures

Abstract Introduction: Rabies is known to be 100% fatal. Equine rabies immunoglobulin (ERIG) recipients are prone to hypersensitivity reactions following administration. This study aims to estimate the adverse events following ERIG among category 3 animal exposures reported in a tertiary care centre in Kerala during the year 2022. Materials and Methods: A record-based descriptive study. Results: Among the 1504 cases, 557 (37.03%) developed sensitivity following the test dose of ERIG, of which 478 were administered with a full dose of ERIG after desensitisation. Human rabies immunoglobulin was given to 26 patients, and monoclonal antibodies were given to 53 patients. Among 1425 who received a full dose of ERIG, 21 (1.5%) developed sensitivity reaction during the observation period, of which 14 had developed sensitivity to the test dose. Of the 21 who developed sensitivity to full dose, 18 patients required only symptomatic management while 3 patients required admission. Conclusion: Testing for sensitivity to test dose will help to identify those in need of premedication with anti-allergic drugs, thereby reducing the risk of hypersensitivity to full dose of ERIG.

Outcomes Of Early And Delayed Intervention Of Maxillofacial Trauma

Background: Maxillofacial trauma is routinely evaluated on the basis of high and low velocity injuries, types of fractures in the literature. On the other hand, we have evaluated them on the basis of timing of surgery after trauma and their outcomes. In India RTA (Road traffic accidents) scenario is quite different from other countries. The highway traffic consists of a variety of vehicles from a cyclist, a two-wheeler, a four-wheeler to a heavy loaded truck. Animals like cows and dogs frequent the highways. Hence, we have classified the patients based on Single jaw and Panfacial fractures with or without the presence of extensive soft tissue injuries. Materials and Methods: In this retrospective record-based descriptive study, 200 patients that were treated at Sri Aurobindo Hospital between January 2023 to July 2024 for maxillofacial trauma were reviewed. Of which 176 patients were surgically operated, averaging 30 years of age and ranging from 12-70 years. For the purpose of our study these 176 patients were categorized into two groups, first of single jaw fractures(108 patients) and second of Panfacial fractures (68 patients). Single Jaw fractures were further divided as mandibular (84 patients); maxilla & zygomaticomaxillary complex fractures (24 patients). These were further evaluated and categorized as those patients who were treated within 72 hours (Early) and after 72 hours (Delayed) following injury. All patients of both the groups were treated with open reduction and internal fixation. Individual complications that of soft tissue dehiscence, plate/bone exposure, bone graft rejection, oroantral/palatal fistula, non-union of fractured segments, infections were analyzed. These complications were again assessed on the basis of their timing; those occurring within 72 hours and those after 72 hours. Results: When each type of complication was compared and evaluated, there was significantly more complication noted among delayed group than in early group. Conclusion: The restoration of the aesthetics and functionality of the face, post-trauma is a critical and an arduous task. As the anatomical complexity of the face must be addressed, timely intervention to achieve optimal functional and aesthetic outcomes is pertinent. Thus, the treatment should be done at the earliest when feasible

Relationship between proxy behavior in clinic attendance and disease control among persons with hypertension and diabetes at a rural primary health center: A cohort analysis in South India

ABSTRACT Aims: Among persons with hypertension and diabetes on treatment for at least 1 year at the Rural Health Centre (RHC) noncommunicable disease (NCD) clinic, 1. To determine the control status for hypertension and diabetes. 2. To assess the relationship between proxy behavior for collection of medications and the control status. Settings and Design: Rural Health Centre, Ramanathapuram, Puducherry, India; record-based retrospective observational study. Methods and Material: The study employed a universal sampling of 396 eligible persons with diabetes and hypertension who had been on medication for over a year at the RHC NCD clinic and had recorded blood pressure and glucose values within the last 4 months. Case sheets of these patients were retrieved from the Medical Registration Department, and data from the past 12 months were collected and analyzed to assess proxy behaviors and absenteeism. Statistical Analysis Used: Data were entered from the case sheets in Epicollect5 and analyzed using Stata v17. Results: Among hypertensive patients, 48.01% were aged 60 and above, with 55.63% being female. Fifty-six percent of hypertensive patients had their condition controlled. For diabetic patients, 40.88% were aged 45–59 years, with 59.75% being female. Only 18.24% of diabetic patients had their condition controlled. The multivariable analysis examined factors associated with the control status of hypertension and diabetes. Those aged 30–44 (aRR: 1.47, 95% CI: 1.01–2.15) and 45–59 (aRR: 1.37, 95% CI: 1.03–1.82) had a higher risk of uncontrolled hypertension compared to those aged 60 and above. Gender did not show significant associations with hypertension control status. Regarding attendance status, patients who had both proxy and missed visits (RR: 1.46, 95% CI: 1.02–2.07) had a higher risk of uncontrolled hypertension. There was also a significant association with patients having more than three proxies (aRR: 1.51, 95% CI: 1.10–2.17) exhibiting a higher risk of uncontrolled hypertension. Absenteeism status showed that those absent for 1–3 visits had a higher relative risk (RR: 1.37, 95% CI: 1.03–1.82) of uncontrolled hypertension compared to those with no absenteeism. Conclusion: Proxy behavior affects the control status of persons with hypertension and diabetes. A longitudinal study is warranted to assess the relationship between proxy visits and control status.

Changes in BMI prior to and during the COVID-19 pandemic among children: a retrospective cohort study in San Francisco, CA

BackgroundThe COVID-19 pandemic led to dramatic changes in the lives of children that impact cardiometabolic health. Cities and counties had varying policies with respect to school closure, recreational programs, and efforts to mitigate food insecurity and economic distress. Our objective was to evaluate changes in BMI-z score and prevalence of overweight/obesity prior to and during the pandemic among children in San Francisco, CA, where public schools were closed for 18-months.MethodsThis was an electronic medical record-based retrospective cohort study. We included 15,401 children, 4–17 years of age at study onset. Our exposure was time into each of three time periods: (1) March 2018-February 2019; (2) March 2019-February 2020; (3) March 2020-August 2021 (the pandemic period of school closure). Generalized estimating equations (GEE) were used to assess changes in BMI-z score and overweight/obesity across the three time periods. We assessed for effect modification by age-category, insurance status, and race/ethnicity.ResultsMean BMI-z score increased by 0.06 per year in time period 2, the year prior to the pandemic (p < 0.001, 95% CI: 0.04, 0.09), and by 0.12 per year during time period 3, the first 18 months of the pandemic (p < 0.001, 95% CI 0.10, 0.13). The proportion of children with overweight/obesity increased by 1.4% points per year during time period 2 (p = 0.012, 95% CI: 0.03, 2.46) and by 4.9% points per year during the first 18 months of the pandemic (p < 0.001, 95% CI: 4.11, 5.67). The effect modification analysis demonstrated that the youngest age group, publicly insured children (versus privately insured), and Black, Latino, and Asian children (versus White children) experienced greater increases in BMI-z score during the pandemic (p < 0.01 for all comparisons). The youngest age group (p = 0.022) and publicly insured children (versus privately insured children) (p < 0.001) also experienced greater increases in the proportion of children with overweight/obesity during the pandemic.ConclusionsAmong children in San Francisco, increases in BMI-z score and overweight/obesity were greater during the pandemic compared to prior changes, with the most pronounced increases among younger and publicly insured children. These findings support the need for more targeted and effective policies for addressing childhood overweight/obesity, especially among these high-risk populations.

Profile of Homicidal Death Cases: One-Year Retrospective Study

Background: Homicide is regarded as a notorious crime against the society that causes intentional killing, aggravated assaults resulting in death. Nowadays, the incidence of homicide is increasing worldwide and it is a matter of great concern all over the world and it has significant consequence for both social and economic security of the people as well as national development. Objective: This study was aimed to describe the pattern homicidal behavior and the relationships among socio-demographic characteristics. Materials and Methods: A record-based retrospective cross-sectional study includes 180 cases of homicide out of the total of 1296 medico-legal autopsies conducted at Forensic Medicine Department of Dhaka Medical College during the year from July 2021 to June 2022. Results: A total number of 1296 medico-legal autopsies were conducted, of them 180(13.89%) cases were homicide and others (RTA, suicide, fall from height, poisoning, hanging, burn) were 1116(86.11%). Out of 180 homicidal death, most of them were 30-40 age group 66(36.67%), 144 cases were male (80 %) and 36 were female (20 %) whereas considering religion, the majority were Muslim 156 in number (86.67%) and the rest were of other religion. Among the homicidal death married were 150 (83.33%), in case of occupation most of them were Jobholder 39 (21.67%). According to the method of homicide, stab wound was the favorite homicide method used over victims 60(33.33%), 36(20%) cases were chop, 30(16.67%) cases were gunshot &amp; strangulation and 24(13.33%) cases were others causes. Regarding place of residence of most of them were from Shahbag thana 108(60%). Conclusion: Stab wound was the favorite homicide method in Bangladesh and the most common age of the victims were 30-40 age group. The usefulness of the data in the scientific community is the database of homicide that should be advantageous for pathologists and forensic scientists work and particularly to be a guideline for homicide investigations in Bangladesh. KYAMC Journal Volume: 15, No: 01, April 2024: 25-28.

Comparison of Truenat Mycobacterium tuberculosis with line probe assay for the diagnosis of rifampicin resistance and mutation pattern of Mycobacterium tuberculosis

Abstract Background: There is an increasing incidence of multidrug-resistant tuberculosis (TB)/preextensively drug-resistant TB (XDR TB) and XDR TB globally. Therefore, rapid diagnostic tests with good sensitivity and specificity are need of hour. Truenat Mycobacterium tuberculosis (MTB) is one such test which gives results in 1–2 h and can withstand a variety of environmental conditions. Objective: The objective of this study was to compare Truenat MTB with line probe assay (LPA) for the diagnosis of rifampicin resistance and to study the mutation pattern of MTB. Materials and Methods: A comparative record-based study was carried out among 325 patients with multidrug-resistant TB. Sputum samples for pulmonary TB and appropriate site samples for extrapulmonary TB were obtained and tested with Truenat-MTB and LPA. A comparison between results obtained by Truenat-MTB and LPA was done. Based on first-line-LPA and second-line-LPA, gene mutation pattern was studied. Results: Males (69.2%) were more than females (30.8%). 30–49 (34.5%) years of age were most commonly affected. The sensitivity, specificity, positive predictive value, and negative predictive value of Truenat MTB compared to LPA were 82.86%, 93.45%, 60.41%, and 97.83%, respectively. The most common gene mutation observed was katG MUT1 in 59 cases. This was followed by rpoB MUT1 in three cases, rpoB MUT2A in two cases, rpoB MUT2B in four cases, and rpoB MUT3 in 12 cases. gyrA mutation was seen in nine cases among which gyrA MUT3A was seen in one case, gyrA MUT3B in one case, and gyrA MUT3C was seen in four cases. Two cases of rrs MUT1 were seen. Five cases of inhA MUT1 were seen. Conclusion: Truenat has been found to be economical, less time-consuming, giving fast results, and accurate in the diagnosis of DR-TB. The most common gene mutation observed was katG MUT1 in 59 cases.

A Record-Based Study on Epidemiological and Clinical Characteristics of Measles Patients Admitted in a Tertiary Care Hospital of Ahmedabad City, Gujarat

A Record-Based Study on Epidemiological and Clinical Characteristics of Measles Patients Admitted in a Tertiary Care Hospital of Ahmedabad City, Gujarat

Evaluation of early and systematic ultrasound examination to determine postoperative dehiscence after small intestinal surgery (114 cases in dogs and cats).

To evaluate the feasibility and reliability of early ultrasound diagnosis for postsurgical bowel dehiscence and find the most reliable ultrasound criteria for dehiscence identification. Additionally, to determine the impact of early ultrasound detection of leakage in terms of survival and duration of hospitalization. Finally, to assess the need for systematized screening or checkup of the population at risk of dehiscence only. 31 cats and 83 dogs. A retrospective, records-based study was performed on 83 dogs and 31 cats (114 total) undergoing small intestinal surgery. Epidemiologic data, clinical signs, surgical procedures, pre- and postoperative ultrasound findings at 48 to 96 hours, hospitalization duration, complications, and general outcomes were recorded. Univariate and multivariate analyses were used to identify ultrasound findings associated with dehiscence. Dehiscence was suspected by ultrasound for 0 of 31 cats and 7 of 83 dogs (2 of 49 for enterotomy and 5 of 34 for enterectomy). Every suspected dehiscence was confirmed during revision surgery except one enterectomy revision, which was declined by the owner. Neither this case nor those without ultrasound evidence of dehiscence developed clinical signs of intestinal leakage. Direct visibility of wall discontinuity, presence of gas bubbles, and liquid in vicinity of the intestinal surgical site were statistically associated with early dehiscence. Survival rate after the second surgery was 83%. Median hospitalization time after the second surgery for dehiscence was 2 days (minimum, 2 days; maximum, 4 days). Postoperative ultrasound examination between 48 and 96 hours after intestinal surgery allows early and sensitive detection of intestinal dehiscence. Survival rate after revision surgery was significantly higher than that associated with septic peritonitis.

Characteristics, clinical profiles, and outcomes of patients undergoing endovascular thrombectomy: A retrospective study, Saudi Arabia

BackgroundStroke is a significant contributor to both mortality and compromised physical function. Endovascular thrombectomy (EVT) is now the recognized standard of care for anterior circulation acute ischemic stroke (AIS) with large vessel occlusion (LVO), especially when favorable brain images are evident within 24 h of symptom onset. This study elucidated the characteristics, clinical profiles, and outcomes of patients who underwent EVT for AIS. MethodologyIn this retrospective record-based cohort study, we reviewed the medical records of individuals who underwent EVT for AIS at King Fahad General Hospital in Jeddah, Saudi Arabia. The study, conducted from July 2022 through October 2023, encompassed a comprehensive analysis of clinical, radiological, and time-related factors and diverse outcomes. ResultsIn a cohort of 117 patients with a mean age of 58.5 years, 81 (69.2%) were male. Hypertension and diabetes mellitus were the most common risk factors, affecting 48.7% and 41% of the cohort, respectively. Approximately half of the patients had a favorable ASPECT Score (7–10), and 45.3% received intravenous tissue plasminogen activator (tPA). Nearly two-thirds achieved a modified thrombolysis in cerebral infarction (mTICI) score of 2b or higher, and 39.3% exhibited M1-middle cerebral artery (MCA) occlusion. The incidence of symptomatic hemorrhagic transformation was about 13%, whereas one-third of the patients attained a favorable mRs outcome (0–2). Factors such as advanced age, higher NIH Stroke Scale (NIHSS) scores, and prolonged hospital stays were associated with poorer outcomes. Conversely, the absence of hypertension and atrial fibrillation, along with higher TICI scores, significantly increased the likelihood of favorable outcomes, with P values of 0.015, 0.0490, and 0.025, respectively. ConclusionsIn our study, the examined patients who underwent EVT were younger in age, with clinical and radiological outcomes showing some degree of comparability to other publications. Notably, the absence of hypertension and atrial fibrillation, combined with a higher TICI score, was associated with an increased likelihood of achieving a favorable outcome.

Resistance pattern and profile of patients with drug-resistant tuberculosis at a tertiary care center

Abstract Background: Studies on resistance pattern and profile of patients with drug resistant tuberculosis (DRTB) are valuable as they provide insights into what are the rates of DRTB locally. Based on these data, treatment may be optimized. They also help in prevention of spread of DRTB elsewhere due to appropriate treatment. Objective: The objective is to study drug resistance pattern and profile of patients with DRTB. Materials and Methods: The present study was record-based study among records of 194 DRTB patients from December 2021 to May 2024. Their age, sex, height, and weight were recorded. From height and weight, body mass index was calculated. Patient status like pulmonary or extra-pulmonary tuberculosis (TB) was noted. Resistance pattern was also observed. Results: The incidence of DRTB was most common in 19–39 years (47.9%). Males were more affected (70.1%). Underweight was most common (78.3%). Pulmonary TB was most common form of TB (93.3%). Multidrug-resistant TB (MDR-TB) was most commonly seen (64.9%). Pre-extensively drug-resistant TB (XDR-TB) was next common (14.9%). XDR-TB was seen in only two cases. Majority (46.9%) were started on shorter oral regimen (Bedaquiline) followed by all oral longer regimen in 34%. All cases of extrapulmonary TB had MDR-TB and no one had XDR-TB or pre-XDR-TB. Conclusion: Thus, we conclude that young adults, males were commonly affected. Underweight is very common in these cases. Pulmonary TB is the leading form of TB in DRTB patients. XDR-TB is not so common form in DRTB cases. Pre-XDR-TB is more common than XDR-TB.

A Retrospective Study of Pattern of Abnormal Findings in Routine Screening Investigations Done of Psychiatry Inpatients in Tertiary Care Teaching Hospital

Abstract Introduction: Physical comorbidity in persons with mental illness is a rule rather than exception. Hence, regular screening investigations in psychiatry inpatients help to detect physical illness at early stage. Aims and Objectives: The aim of this study was to evaluate the results of various screening investigations, referral patterns, and physical comorbidities in psychiatric inpatient records. Methodology: This was a descriptive, analytical, record-based study conducted in the psychiatry department of a tertiary care teaching hospital, wherein case notes of all inpatients admitted to the psychiatry unit during 6 months (January–June 2023) were studied. Inpatient records were evaluated for sociodemographic details, indication for admission, investigations as needed, any physical comorbidity, treatment history, referral patterns, and their outcomes. Records with incomplete details and known physical illnesses mentioned were excluded. Results: Total 100 patients’ records (63 males; mean age = 35 years, 37 females; mean age = 41 years) were included in the study. The common diagnosis was mood disorder 36% (n = 36), followed by substance use disorder 30% (n = 30) and schizophrenia 22% (n = 22). On evaluating investigations, abnormalities found were anemia, diabetes mellitus, hypertension, and thyroid disease (42% [n = 42/100], 24% [n = 24/100], 22% [n = 22/100], and 22% [n = 22/100], respectively). Magnetic resonance imaging (MRI) brain changes were seen in 75% of patients with acute behavior disturbances (n = 4) and MRI spine changes in all major depressive disorder patients presented with backache (n = 4). Ultrasonography abdomen findings were abnormal in 68% (n = 26/38), of which 80% (n = 21/26) had substance use disorder. For the management of abnormal findings, the referral consultation rate was 76% (n = 76/100); 86% (n = 66/76) of patients required more than one consultation with total 154 referrals. Conclusions: The investigations as indicated help in early detection and management of physical illness which mostly remains out of sight due to psychiatry illness.

Morbidity profile of the patients attending Mobile Medical Unit camps in Telangana – a record-based study

Introduction: Mobile Medical Units (MMUs) were one of the major initiatives under the National Rural Health Mission. These MMUs help in reaching the unreached. It helps people in remote, underserved areas to access healthcare at affordable prices at their doorstep. Objectives: In this study, we aim to assess the morbidity profile of the patients attending Mobile Medical Unit camps in Yadadri-Bhuvanagiri district between April 2022 to December 2022. Methodology: This is a record-based study. MMU is run by department of Community and Family Medicine, AIIMS, Bibinagar in six selected villages of Yadadri-Bhuvanagiri district. (Fig.1). A register is maintained for recording the details of patients visitingthe MMU camp. Patient’s name, age, gender, place, mobile number, height, weight, blood pressure (BP), glucometer based Random Blood Sugar (GRBS), diagnosis, and details of medication dispensed were entered in the register. Diabetes was diagnosed using the WHO criteria , hypertension using the Eighth Joint National Committee guidelines , obesity using the WHO Asia Pacific guidelines. Mobile Medical Unit camp data is entered into excel database at the end of every month. As it is a record-based analysis, we used data between April 7th 2022 to December 31st, 2022 for analysis. Results: A total of 1494 patients were treated in the MMU camps during this period. Among them 89.4% were adults &amp; 10.6 % were children (less than 18 years). Among 1336 adult patients, majority of the study participants suffered from osteoarthritis followed by non-communicable diseases. The mean systolic BP of the adult population was 131 (±21) mmHg and diastolic BP of the population was 77 (±13) mm Hg. The mean random blood glucose levelof the adult Population was 150 (±74) mg/dl. A total of 158 children were less than 18 years, out of which 78 participants were males and 80 participants were females. Majority suffered from upper respiratory tract infections among males (23.1%) and females (25%) respectively. Conclusion: The study further suggests that NCD epidemic is spreading to rural areas where necessary health infrastructure is insufficient. MMUs can bring a significant change in the public health system, which needs to re-orient its priorities.

P023 THE CLINICAL SPECTRUM OF COVID-19 SEVERITY AND OUTCOME ON HOSPITALIZED PATIENTS AT JABRA ISOLATION CENTRE – SUDAN, 2021

Background: The COVID-19 pandemic has highlighted how crucial to comprehend the various clinical presentations of the illness to improve patient treatment and healthcare resources. Objective: To investigate potential gender-based disparities in the severity and outcome of COVID-19 patients in Jabra Isolation Center 2021 Methodology: A descriptive-analytic record-based study was conducted at Jabra Isolation Centre, Sudan, 2021. A random selection of 317 patients was performed. The three zones of severity were: mild (ward stay, Green Zone), moderate (high dependence unit, Yellow Zone), and severe (intensive care unit, Red Zone). Fever, SOB, cough and SPO2, and mortality based on the 3 zones and gender distribution were analyzed by MOH triage procedure checklist using SPSS(version 21) Results: The age ranged between 25-91 years. The findings were as follows: At Green Zone, 46.63% of patients were admitted, with 65.91% being males, The hypertensive patients were 38.16%, and the diabetic were 39.47%. The presenting signs were fever, SOB, cough, and SPO2 (77.39%, 67.11%, 56.58%, and 92% respectively). The mortality rate was 52.63%. While at Yellow Zone, 15.64% of patients were admitted, with 75% being males. The hypertensive patients were 49.02%, and the diabetic were 39.22%. Fever, SOB, cough, and SPO2 were (78.43%, 74.51%, 70.59% and 90% respectively). The mortality rate was 49.02%. At the Red Zone, 37.73% of patients were admitted with males 61.05%. The hypertensive patients were 45.53%, and the diabetic were 36.59%. Fever, SOB, cough, and SPO2 (65.85%, 71.54%, 43.9%, and 92% respectively). The mortality rate was 62.6%. The mortality rate across all 3 zones of severity was 55.83% of which males were 66.0%. Conclusions: This study showed that COVID-19 hospitalized patients at Jabra Isolation Centre in 2021 were predominately males and associated with hypertension and diabetes at 3 zones of severity. The mortality rate was highest at the Red Zone. The overall mortality rate was 55.83% of which males were 66%.

A cross-sectional epidemiological study of animal bite victims in district hospital Alwar, Rajasthan, India

Background: Rabies, an invariably fatal viral disease, transmitted to humans through animal bites, mostly dogs. According to WHO, each year, 23000-25000 people die in the SEA region due to rabies. These accounts for approximately 45% human deaths due to rabies worldwide. Objective was to study epidemiological trend of animal bite in Alwar district hospital. Methods: A retrospective, record-based study was conducted in 200 animal bite victims presenting to district hospital Alwar, Rajasthan wherein information on monthly number of animal bite cases was collected from records section of the hospital. Information on annual number of animal bite cases was available from the annual report of the hospital from 2018 onwards, this data was used for studying the monthly variation in animal bite cases. Data were compiled and analyzed using Microsoft Excel. Results: Among 200 victims 76.3% were males, 56.7% belongs to 15-45 years, 61.6% were living in urban area, 31.3% and 21.7% of the victims were agriculture worker and laborers respectively. Among 95.8% victims bitten by dog, 89% of them were stray. 89.4% had category III bite, lower extremity affected in 60.8%, fate of animal was unknown in 78.6% and 46% of the victims were bitten during evening hours. Conclusions: Majority of bites were by stray dogs, unprovoked and category III bites. This indicates the need of large amount of anti-rabies serum or HRIG thereby increasing the cost of management of animal bite cases. There is a need to control stray dog population and immunize pet dogs.

Antibiotic Usage Pattern against COVID-19 in Patients of a Tertiary Care Hospital

The coronavirus disease of 2019 (COVID-19) emerged as a pandemic at the end of 2019. The clinical presentation of COVID-19 was comparable to bacterial infections, and due to the ambiguity of an effective treatment method, the healthcare professionals routinely used antibiotics to treat the patients. So, this study evaluated the antibiotic usage patterns at our hospitals among COVID-19 patients, considering the World Health Organization (WHO) AWaRe (Access, Watch, and Reserve) classification. The present study was a retrospective observational hospital record-based study on COVID-19 patients admitted from March-August 2020. A total of 256 COVID-19 patients were enrolled, considering inclusion and exclusion criteria. Data collection utilizing a standardized case record form to capture all information methodically based on age, sex, comorbidities, duration, and nature of the symptoms. Drug data, for example antibiotic usage patterns were collected with detailed prescription analysis, including route, dose, frequency and number of antibiotics used. A structured proforma was used to analyze data, and descriptive statistical analysis was performed and presented as Histograms. The WHO AWaRe antibiotic classification was used to determine the antibiotics’ suitability for empirical therapy. The mean age of the participants was 40.00 ± 15.46 years with male predominance, 188 (73.43%) in number, compared to females, with 68 (26.56%). Almost all the current study participants received one or more antibiotics during their hospital stay, and a maximum of the patients 126 (49.22%) received 2 antibiotics during treatment, 78 (30.47%) subjects who were managed with 3 antibiotics, and the rest, 52 (20.31%) participants received only 1 antibiotic during their hospital stay. To treat moderate to severely ill patients, the most used antibiotic was doxycycline, followed by meropenem and piperacillin/tazobactam. The findings of this study will provide baseline data that will help to generate strategies to reduce antibiotic prescriptions for the formulation of better antibiotic stewardship programs (ASP) and institutional policies to fight against any infection in a better way in the near future.

Clinico-Laboratory Profile of Hypertriglyceridemia Thalassemia Syndrome: A Case Series in a Paediatric Tertiary Care Centre.

Increased hemolysis and repeated blood transfusion trigger oxidative stress resulting in numerous adverse effects in beta-thalassemia patients. Extreme elevation of triglyceride level is a rare clinical entity seen in these patients. It is presumed to be caused due to an increase in oxidative stress and is termed Hypertriglyceridemia Thalassemia Syndrome. To assess the clinical and laboratory characteristics of beta-thalassemia patients presenting with hypertriglyceridemia and its correlation with the pre-transfusion hemoglobin level. Methods: This hospital record-based retrospective study was conducted at the Dr B C Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India. The study comprised 12 pediatric beta-thalassemia patients whose plasma appeared milky or chylous during a complete hemogram. Clinical examination and laboratory investigations were done to describe their clinico-laboratory features. A whole exome sequencing was carried out to assess their genetic background. Blood hemoglobin and serum triglyceride estimation was carried out initially and at follow-up to determine any correlation between the two. Results: Out of 1482 patients, 12 (0.80 %) were diagnosed with Hypertriglyceridemia Thalassemia Syndrome. The median age of presentation was 12.5 months (Q1:10 months, Q3:14 months)., and the pretransfusion hemoglobin was 4.82 ± 1.16 g/dL. The lipid profile showed a triglyceride level of 858.3 ± 198.4 mg/dl and a total cholesterol level of 117.4± 16.15 mg/dl. Analysis revealed that the triglyceride levels were negatively correlated with the pretransfusion hemoglobin level (repeated measures correlation (rmcorr) = -0.65, 95% CI[-0.794, -0.425], p < 0.001). A genetic study highlighted c.92+5G>C as the commonest mutation. Hypertriglyceridemia was a rare presentation in transfusion-dependent beta-thalassemia patients. The serum triglyceride level significantly reduced when blood transfusion at regular intervals restored the patient's hemoglobin level.

Resistance Pattern of Klebsiella pneumoniae in Aseer Region, Saudi Arabia: A Ten-Year Hospital-Based Study.

Background and Objectives: The frequency of multidrug-resistant Klebsiella pneumoniae (MDRKP) has dramatically increased worldwide in recent decades, posing an urgent threat to public health. The aim of this study was to assess the extent of K. pneumoniae in the Aseer region and explore the corresponding antimicrobial resistance profile over the last ten years. Materials and Methods: A record-based retrospective study was conducted in a tertiary hospital during the period of 2013 to 2022. The study targeted laboratory samples taken from patients admitted to the hospital and sent for K. pneumoniae culturing. We included only samples taken from the patient and confirmed by the lab. Data were extracted using a pre-structured data extraction sheet to avoid data-collection bias and confirm the inter-rater precision. Statistical Package for Social Sciences (SPSS) version 26 was employed for statistical analysis. All relationships were tested using Pearson X2 test for categorical data or chi-square for linear trend for resistance rate over years. Results: We obtained 3921 samples of isolated K. pneumoniae out of 28,420 bacterial samples. The isolation rate began at 11.3% in 2013, decreased to 6.1% in 2016, and then increased to a peak of 16.3% in 2021, before slightly decreasing to 12.8% in 2022. In total, 23.7% of K. pneumoniae samples were identified in urine samples, 19% in sputum samples, 14% in wound samples, and 11.7% in blood samples. The overall antibiotic resistance rate of K. pneumoniae from 2013 to 2022 showed a significant increase, particularly during 2020 and 2021, before decreasing again in 2022. The resistance rate decreased from 22.2% in 2013 to 18.6% in 2016 and increased to 54.6% and 56.4% during 2020 and 2021, respectively (p = 0.039). Conclusions: We observed a significant shift in K. pneumoniae resistance for some antibiotics during the study period, highlighting the urgent need for enhanced antimicrobial stewardship and infection-control measures.