Tertiary Care Hospital In Ahmedabad Research Articles

Study of the knowledge, attitudes and practices of parents of children with bronchial asthma in a tertiary care hospital in Ahmedabad

Study of the knowledge, attitudes and practices of parents of children with bronchial asthma in a tertiary care hospital in Ahmedabad

Clinicoradiological Profile of Patients Having Drug-Sensitive Pulmonary Tuberculosis With and Without Diabetes Mellitus in a Tertiary Care Hospital in Ahmedabad, Gujarat, India.

Background A significant effect of diabetes mellitus (DM) on the clinical and radiological features of tuberculosis (TB) has been reported. However, conflicting results have also been reported. Hence, a conclusion is yet to be drawn. This study aimed to analyze and compare the clinical and radiological features of drug-sensitive pulmonary TB with DM and without DM. Methodology A comparative, observational study was conducted between August and October 2023. Patients with drug-resistant TB, extrapulmonary TB, those on immunosuppressive drugs, and human immunodeficiency virus-positive individuals were excluded from this study. Pulmonary TB patients with DM were classified as the case group and those without DM were classified as the control group. Demographic details, clinical symptoms, detailed past and family histories of comorbid conditions, laboratory investigations, sputum acid-fast bacilli results, and chest X-ray findings were noted. The diagnosis of TB and grading of sputum smear results were done by following the National Tuberculosis Elimination Program guidelines. Results A total of 40 patients, 20 (50%) cases and 20 (50%) controls, were enrolled in this study. Clinical symptoms were almost similar in both groups except for dyspnea (80% vs. 40%) and hemoptysis (75% vs. 35%), which were significantly predominant in the case group. Lower zone involvement in chest X-ray was significantly (p = 0.0079) more in the case group (75%) compared to the control group (40%). Cavitary lesions were also significantly higher in the TB with DM group (p = 0.031). Bilateral lesions and multiple zone involvement were also more common in the case group, although no statistically significant difference was seen. Additionally, thehematological parameters of the two groups differed; however, the findings were not statistically significant. Conclusions Based on our findings, we recommend screening all TB patients for DM. Similarly, all high-risk DM patients should be screened for TB for early diagnosis and management, thereby reducing morbidity and mortality. Physicians should be aware that people with DM may present with pulmonary TB in an atypical manner.

Assessment of Physicochemical and Microbiological Qualities of Drinking Water in Ahmedabad Slum, India: A Cross-Sectional Study

ntroduction: The quality of drinking water is a public health concern, especially in urban slum areas. Drinking water quality and contamination are seriously threatened by the growing slum population and irregular water supply. Objective: To examine the physicochemical and microbiological quality of drinking water in the field practice area of one of the Tertiary-care hospital in Ahmedabad a part of PG teaching activity. Method: A cross-sectional study was carried out for water quality assessment using stratified random sampling. A total of 139 water samples were collected; samples were collected from different households in different areas of the Asarwa ward of Ahmedabad Corporation. From each ASHA worker’s area, according to population of that area, 6 to 10 samples were selected. The samples were analysed using standard methods and compared with WHO and BIS water quality standards. Results: TDS and alkalinity are above permissible levels in 42.4% and 46.7% samples respectively. pH, turbidity, conductivity, total hardness, and magnesium were found altered in a few samples. The mean free residual chlorine was 0.05 mg/L. Microbiological analysis of water samples revealed the presence of coliform in 5 (3.6%) samples. Conclusion: Except for total alkalinity and TDS, most physicochemical parameters of drinking water were acceptable. By storing water, a low level of free residual chlorine can be justified. A few samples (3.6%) with coliform bacteria indicate water contamination somewhere in the distribution system or at the consumer level.

Study of profile of acute viral hepatitis in hospitalized children at a tertiary care center in Gujarat

Background: Viral hepatitis is a significant public health problem throughout the world affecting millions of children. Aims and Objectives: The objective of the study was to determine the profile of acute viral hepatitis (AVH) in pediatric patients admitted in a tertiary care hospital in Gujarat. Materials and Methods: This prospective and hospital-based study was done in a tertiary care hospital in Ahmedabad, Gujarat, India from August 2019 to July 2021. Children up to 14 years of age with AVH who fulfilled the inclusion criteria were included in the study. Results: Mean age of presentation was 8.08 years. Males were more affected than females with male: Female ratio of 2:1. Majority of patients had a history of eating unhygienic food and drinking unsafe water. About 88% were vaccinated for hepatitis B. None of them was vaccinated for hepatitis A. The most common symptoms at presentation were fever (94%), abdominal pain (78%), vomiting (76%), dark colored urine (76%), yellow eyes (73%) and decreased appetite (61%). The most common clinical sign noted was jaundice followed by hepatomegaly. Hepatitis A was the most common etiological agent (86%) followed by hepatitis E (8%). Mixed infection with hepatitis A and E was also seen (4%). There was no mortality. Conclusion: It is very important to create awareness regarding preventive measures such as hygienic food practices, improved sanitation, and increased rates of vaccination for the prevention of viral hepatitis.

Comparison of the Efficacy of Light's Criteria With Serum-Effusion Albumin Gradient and Pleural Effusion Glucose.

Introduction While Light's criteria exhibit high sensitivity (98%) in detecting exudative pleural effusions, the capacity to rule out transudates is relatively limited. A previous study showed thatapproximately one-fifth of patients with congestive cardiac failure on diuretics also met the criteria for exudate. This study compares the diagnostic value of Light's criteria, the serum-effusion albumin gradient (SEAG) method, and pleural effusion glucose levels for accurately categorizing pleural effusion as transudate or exudate. Methodology We conducted this cross-sectional observational study in a tertiary care hospital in Ahmedabad, India. Two hundred patients with pleural effusion undergoing thoracentesis were included. Laboratory parameters measured in pleural fluid analysis included pleural fluid protein, pleural fluid lactate dehydrogenase (LDH), pleural fluid albumin, and pleural fluid glucose. Serum protein, serum LDH, and serum albumin were also collected. Mean values and standard deviations (SDs) were calculated for analysis. Results A significant difference was observed in the mean value of exudative and transudative effusions for each parameter (pleural fluid protein/serum fluid protein ratio, pleural fluid LDH/serum fluid LDH ratio, pleural fluid LDH, SEAG, and pleural fluid glucose) (P < 0.001). Light's criteria demonstrated the highest efficacy in diagnosing exudates (accuracy = 97.50%), while SEAG demonstrated the highest efficacy in diagnosing transudates (accuracy = 97.50%). Conclusion SEAG is an effective alternative diagnostic tool for identifying transudates misclassified by Light's criteria. Its use can contribute to prompt diagnosis and timely treatment of patients with pleural effusion, improving patient outcomes.

Dehydration fever in exclusively breastfed neonates at a tertiary care center – A cross-sectional study

Background: Dehydration fever is one of the most common non-infectious causes of fever in newborns. It can be very dangerous and can lead to serious complications and even death. Early recognition of dehydration fever by serial monitoring of weight to detect inappropriate weight loss and early correction of dehydration fever can prevent disastrous complications in the baby. Aims and Objectives: The aim was to study the incidence and clinical profile of dehydration fever in exclusively breastfed neonates admitted at tertiary care hospital. The primary objective is to know the incidence of dehydration fever in exclusively breastfed neonates. Secondary objectives are to study the clinical and laboratory profile of dehydration fever and to study the management and outcome of dehydration fever in terms of morbidity and mortality. Materials and Methods: The study was conducted in the Department of Pediatrics of a tertiary care hospital in Ahmedabad, Gujarat. Neonates between 0 and 28 days of life born at full term (37–40 weeks of gestation), on exclusive breastfeeding and having an axillary temperature of &gt;37.5°C/100.4°F and clinical signs of dehydration were included in the study. Clinical and laboratory profile of neonates with dehydration fever was noted. Results: The incidence of dehydration fever was 4.71/100 neonates (152 out of 3225 neonatal admissions). Maximum cases were noted in May. The most common predisposing factor was primiparity (n = 119 [78.28%]), followed by the poor establishment of breastfeeding (n = 117 [76.97%]) and cesarean section delivery (n = 97 [63.81%]). Among 152 neonates with dehydration fever, 118 neonates (77.64%) had hypernatremic dehydration and 34 (22.36%) had isonatremic dehydration. All the neonates with dehydration fever were successfully treated. No deaths were observed in the present study. Conclusions: Dehydration fever is an important cause of neonatal fever in tropical countries like India, especially during the summer months. The present study highlights the need to be vigilant about dehydration, hypernatremia, and hyperbilirubinemia in breastfed neonates while emphasizing the need to promote exclusive breastfeeding. Dehydration fever can be prevented by educating mothers regarding breastfeeding techniques, beginning in the antenatal period. Those with identifiable problems should be referred promptly for lactation management and supportive counseling.

Can Pulmonary Rehabilitation Improve the Well-being of COPD Patients: Experience at a Tertiary Care Hospital in Ahmedabad, Gujarat, India

Can Pulmonary Rehabilitation Improve the Well-being of COPD Patients: Experience at a Tertiary Care Hospital in Ahmedabad, Gujarat, India

Linking PM Pollution to the Respiratory Health of Children: A Cross-sectional Study from Ahmedabad City in Western India

Worldwide research on public health suggests that air pollution (AP) has deleterious human health impacts. Children living in developing countries suffer a double burden of respiratory diseases. The present study aims to find out the risk of short-term exposure to PM2.5 on respiratory admissions of children under 6 from Ahmedabad city in western India. A cross-section observational study of all patients, under 6, with respiratory illnesses admitted in the Pediatric ward from 1st November 2017‒31st December 2018 at a tertiary care hospital in Ahmedabad has been conducted to decipher the seasonal impact of PM2.5 on respiratory admissions. During the study period, respiratory illnesses accounted for 21.2% of the total admissions−60.6% were male, 48.4% were of infant age, 60.1% of the patients were suffering from wheezing disorders while 39.9% had infective disorders. The relative risk (RR) and the number of attributable cases per 100,000 children population at risk were estimated due to short-term exposure to PM2.5 for different seasons in Ahmedabad city applying a log-linear integrated exposure-response function in WHO/Europe’s AirQ+ tool using national census-2011 city-level population of children and United Nation’s annual growth-rate, baseline incidence, PM2.5 pollution profile, WHO’s updated counterfactual value for short-term PM2.5 exposure (= 15 µg m–3). Accordingly, the RR for the number of respiratory admissions of children due to ambient levels of PM2.5 in winter was 1.16 (95% CI: 1.09−1.23), in summer was 1.15 (95% CI: 1.09−1.21), in monsoon was 1.08 (95% CI: 1.03−1.13) and in post-monsoon was 1.15 (95% CI: 1.07−1.23). The number of attributable cases (along with confidence interval: CI), per 100,000 population of children under 6 at risk, was 45 (95% CI: 21‒68) in winter, 41 (95% CI: 19‒63) in summer, 25 (95% CI: 11‒39) in monsoon, and 42 (95% CI: 18‒66) in the post-monsoon season.

Cut Throat Injury: A Tertiary Care Centre Experience

Introduction Cut throat injuries are one of the challenging emergencies encountered in clinical practice. This study evaluates the causes and management of cut throat injuries. Materials and Methods This was a retrospective study of total 100 cases of cut throat injury presented to the department of ENT in a tertiary care hospital in Ahmedabad between June 2017 and June 2019. Majority of patients were managed by suturing. Results In our study 69% were males,31% were females. The peak age of incidence is 4th decade (55%). 70% of them have injury in Zone II. Seventy eight percent of the patients presented with active bleed without major vessel injury. The most common cause of cut throat injury had been found to be accidental (75%), 54% had injury up to muscular layer. Five patients were managed by laryngotracheal stent placement. Conclusion The middle aged males were mostly affected. The majority had zone 2 injury. The most common cause was Accidental (seasonal manja/ kite thread cut). Primary repair is the best way to avoid complications.

Brought dead cases at a tertiary care hospital in Ahmedabad with reference to dispensing with the need of medico legal post-mortem examination: Provisions, Protocol &amp; Procedure

Brought dead cases are of concern not only clinically with regards to medical certification of cause of death, but also medico legally. Generally, brought dead cases are considered as medico legal, which in fact need not be always. Need has arisen to study the provisions and practice of handling brought dead cases with respect to whether medico legal post-mortem is required for all such cases or not. A retrospective, cross-sectional, observational study was carried out by examining case files, police papers and postmortem reports of brought declared dead cases (n=62) received at a tertiary care hospital in Ahmedabad with the objective being to observe the epidemiology of brought dead cases and to review the provisions and practice of handling brought dead cases, as well as, medico legal post-mortem examination (Under S. 174 Cr P..C.) for such cases. Majority cases belonged to more than 50 years of age with a history of previous/current major illness. Hence, ascertaining the cause of death became quite obvious after excluding common unnatural causes. Only 23.72% cases were subjected to autopsy. In some cases police denied permission for performing the autopsy. A protocol to handle brought dead cases is suggested which might require some reforms in relevant law(s) and state resolutions. The centers with high load of autopsies of brought dead cases from natural manner should carry out such a study to decide whether really medico legal autopsy is required in such cases or not and to request the state authorities to amend the provisions accordingly.

Seroprevalence of hepatitis C virus in voluntary blood donors at a tertiary care hospital, Ahmedabad, India

Background: Hepatitis C virus (HCV) is the most common cause of post transfusion non-A, non-B hepatitis worldwide. The prevalence of HCV in blood donors in high-income countries ranges from 0.002% to 0.05%, in middle-income countries ranges from 0.03% to 0.80%, and in low-income countries, prevalence varies from 0.50% to 2.23%. Objectives: The objectives of this study are to assess the seroprevalence and the trend of HCV in healthy voluntary blood donors at a tertiary care hospital in Ahmedabad over a period of 3 years. Settings and Design: Observational, retrospective study. Materials and Methods: During January 2017 to December 2019, 9477 voluntary blood donors were tested for the presence of anti-HCV antibody by using a 3rd-generation enzyme-linked immunosorbent assay test. Statistical Analysis Used: Data were statistically analyzed by using the Chi-square test, and Chi-Square test for linear trends using the Statistical Package for the Social Sciences (SPSS) software trial version 19. Results: Out of 9477 voluntary blood donors, 9229 (97.38%) donors were male and 248 (2.62%) were female. Ten donors (0.11%) were positive for anti-HCV. All seropositive donors were male. Out of total 0.11% seropositive donors, maximum (0.07%) were within the age group of 21–30 years. Seroprevalence of HCV showed a statistically significant decreasing trend over 3 years. Conclusion: Hepatitis C is a common cause of transfusion-related hepatitis. Early identification of persons with chronic HCV infection would enable infected persons to receive the necessary care and treatment to prevent or delay the onset of liver disease.

Performance of HEART and TIMI scores in predicting major adverse cardiovascular events (MACEs) of chest pain patients in the emergency department: A prospective observational study

Objective: To compare the value of HEART and TIMI scores in predicting major adverse cardiovascular events (MACEs) of patients with chest pain in the emergency department at a tertiary care hospital in Ahmedabad, a city in western India. Methods: A prospective study was conducted on chest pain patients from January to December 2019. All adult patients with non-traumatic chest pain presenting to the emergency department were included, and their HEART and TIMI scores were evaluated. The patients were followed up within 4 weeks for monitoring any major adverse cardiac events or death. The receiver-operating characteristics (ROC) curve was used to determine the value of HEART and TIMI scores in predicting MACEs. Besides, the specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of the two scores were assessed and compared. Results: A total of 350 patients were evaluated [mean age (55.03±16.6) years, 56.6% of males]. HEART score had the highest predictive value of MACEs with an area under the curve (AUC) of 0.98, followed by the TIMI score with an AUC of 0.92. HEART score had the highest specificity of 98.0% (95% CI: 96.4%-99.6%), the sensitivity of 75.0% (95% CI: 70.7%-79.3%), and PPV of 97.0% (95% CI: 94.1%-99.9%) and NPV of 82.5% (95% CI: 74.6%-90.4%) for low-risk patients. TIMI score had a specificity of 95.0% (95% CI: 92.4%-97.6%), sensitivity of 75.0% (95% CI: 69.4%-80.6%), PPV of 92.3% (95% CI: 88.1%-96.5%) and NPV of 82.3% (95% CI: 73.8%-90.8%) for low-risk patients. Conclusions: HEART score is an easier and more practical triage instrument to identify chest pain patients with low-risk for MACEs compared to TIMI score. Patients with high HEART scores have a higher risk of MACEs and require early therapeutic intervention and aggressive management.

Retrospective analysis of histopathological spectrum of premalignant and malignant colorectal lesions

Background: Colorectal cancers (CRCs) arise due to the progression of acquired or hereditary premalignant lesions. Therefore, an early diagnosis is essential to devise suitable preventive strategies against CRC. Objectives: We aimed at determining the prevalence and pattern of distribution of premalignant and malignant colorectal lesions and to assess their histopathological features. Materials and Methods: This retrospective study was conducted in the Department of Pathology at the Gujarat Cancer Society Medical College, Hospital and Research Center, a tertiary care hospital in Ahmedabad, Gujarat, India, between August 2018 and July 2020. Patients with malignant or premalignant lesions in the colorectal region who underwent biopsy and surgical resection were included, regardless of their age and sex. They were categorized as premalignant or malignant after the histopathological examination. The clinical history and details related to the age, gender, and anatomical site were obtained from the hospital records. The findings were analyzed using descriptive statistics. Results: A total of 150 colorectal biopsies and resected specimens with premalignant and malignant lesions were included in the analysis. Of these, 36 (24%) were benign and 114 (76%) were malignant. There were 98 (65.3%) male and 52 (34.7%) female patients in the cohort. There were 34.7% of the patients who were in the sixth decade of life and only 0.7% were in the first decade. The most commonly involved site was the rectum (32.7%). Ulcerative colitis (UC) (63.8%) was the most common premalignant lesion, and adenocarcinoma not otherwise specified (79.8%) was the most common malignant colorectal lesion. Conclusions: Premalignant and malignant colorectal lesions usually develop in older persons and have a male predilection, with the rectum being the most commonly involved site. UC is the most common premalignant colorectal lesion, and adenocarcinoma is the most common malignant colorectal lesion.

Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.

Prevalence of TB associated chronic obstructive pulmonary disease in patients with COPD attending at tertiary care hospital in Ahmedabad: A case control study

Background: Apart from tobacco smoke, COPD has been known to occur in patients with previous pulmonary TB. Present study was performed with an aim to conduct a study to discover out the hospital based prevalence of TB‑associated COPD among COPD patients and to assess its distinguishing features in Ahmedabad, Gujarat, India. Present study was conducted at the Department of Tuberculosis and Reparatory Medicine, in a tertiary care hospital over a period of 7 months. Seventy-four consecutive patients of stable COPD attending chest OPD were enrolled as cases. An equivalent number of healthy subjects with comparable age and gender distribution were taken as controls. Specific points such as number of anti‑tubercular treatment (ATT) courses, total duration of treatment, time elapsed since completion of treatment and their final outcome were recorded. The prevalence of TB‑associated COPD group was calculated, and its different parameters were compared with rest of COPD patients. Results: Median duration of onset of symptoms was 4.1 years. The unadjusted odds ratio for previous TB in the COPD group in comparison to controls was 3.95. Most of the patients 21/24 had taken a single course of ATT. TB‑associated COPD patients were significantly younger in age as compared to the rest of COPD patients (P ? 0.05) with more proportion of females. On multivariate analysis, duration of dyspnea retained positive correlation with hospitalizations after adjusting for pack years, age, and BMI. Conclusions: TB‑associated COPD constitutes a substantial proportion of COPD in a hospital setting. It is a distinct clinical entity different from a larger smoking related COPD and hence may require different management. Keywords: COPD; Odds ratio; Prevalence; TB.

COMPARISON OF VARIOUS TECHNIQUES FOR MANAGEMENT OF FISTULA-IN-ANO

INTRODUCTION: Cirrhosis is a condition that is defined histopathologically and has a variety of clinical manifestations and complications, some of which can be life-threatening. Patients with cirrhosis and portal hypertension exhibit characteristic cardiovascular & pulmonary hemodynamic changes. The cardiovascular complications include systolic dysfunction, diastolic dysfunction & electrochemical abnormalities like prolonged QT interval in Electrocardiogram (ECG), and Respiratory complications include Consolidation, Pleural Effusion & Pulmonary Arterial Hypertension, which may be due to Hepatopulmonary or Portopulmonary syndrome STUDY DESIGN: A two-year prospective observational study was conducted from July,2014 to June 2016 AIM: To study the different cardiac and pulmonary complications in the patients of Liver Cirrhosis. MATERIALS & METHODS: A two-year prospective observational study was conducted from July,2014 to June 2016 at a tertiary care hospital in Ahmedabad, Gujarat, India, including 30 patients (>12 years old), who were known cases of cirrhosis of liver as well as those newly diagnosed with it, with cardiopulmonary complications, developed after liver cirrhosis, in the absence of other etiological factors. Clinical profile with laboratory studies and diagnostic tests were studied. RESULTS: This study showed that cardiopulmonary complications in cirrhotic patients are more frequently seen in males than females, which commonly manifest during third & fourth decade. Dyspnoea is the most common symptom seen in the study. Among the pulmonary complications, Pneumonia & Hydrothorax are more common compared to hepatopulmonary & portopulmonary syndromes, and among cardiac complications, Diastolic dysfunction is a major complication in such patients, which increases with increasing severity of cirrhosis, as indicated by CP score. CONCLUSION: Among these patients, Cardiac and pulmonary complications have nearly the same incidences.

Serum immunoglobulin E and absolute eosinophil count as markers of severity in childhood asthma

Background: Asthma is a chronic inflammatory condition of the airways resulting in increased airway reactivity to a variety of stimuli like allergens, irritants, viruses and exercise. There is a strong association between the exposure of allergens and development of asthmatic symptoms. A hypersensitivity reaction initiated by immunologic mechanisms mediated by Immunoglobulin E (IgE) antibodies occurs in allergic asthma. IgE and eosinophils play an important role in the inflammatory process resulting in bronchial hyperresponsiveness. The aim of this study was to evaluate serum total IgE levels and Absolute Eosinophil Count (AEC) as markers of disease activity and study their association with the severity of bronchial asthma in children.Methods: A prospective study was conducted in the paediatric department of a tertiary care hospital in Ahmedabad, Gujarat, India from July 2017 to December 2018. Children between 4-14 years of age diagnosed as having bronchial asthma were included in the study. Serum total IgE levels and absolute eosinophil count were done in all the study participants and their correlation with the severity of asthma was assessed.Results: Of the total 109 patients of asthma, 44(40.4%) had intermittent asthma, 30(27.5%) mild persistent, 25(22.9%) moderate persistent and 10(9.2%) severe persistent asthma. Serum total IgE levels were raised above the normal limits for age in 94(86.2%) patients and increased AEC was found in 61(56 %) patients. Both serum total IgE levels and AEC increased significantly (p&lt;0.0001) with increasing severity of asthma.Conclusions: Serum total IgE levels and AEC can be used to predict the severity of asthma in children.

Evaluation of pattern of bacterial contamination of outpatient department table surfaces in relation to cleaning and disinfection practices in a tertiary care hospital in Ahmedabad.

Outpatient department (OPD) table surfaces frequently touched by patients and health-care workers in hospitals harbor potential pathogens and may act as source of infectious agents. This study aimed to determine the pattern of bacterial contamination of surfaces of OPD tables in relation to existing cleaning/disinfection practices. The descriptive study was conducted during July 2018-September 2018. A total of 128 swabs were collected from 32 OPD table surfaces immediately after cleaning or disinfection and then at 30 min, 2 h, and 4 h interval after cleaning or disinfection. Type and concentration of cleaner or disinfectant, number of cleaning strokes on table, and time of last washing of cleaning cloth with detergent were also noted from each location. Isolation, identification, and antibiotic susceptibility testing of the isolates were performed by standard microbiological techniques. A total of 337 bacterial isolates were recovered from 126 samples. Multidrug resistant Staphylococci, Acinetobacter, Pseudomonas, Klebsiella, and Escherichia coli were isolated. The mean bacterial colony count increased with time (P < 0.0001). Hand rub use, cleaning of OPD table surfaces with disinfectant, and more number of strokes with cleaning cloth resulted in decrease in colony count of bacteria isolated. High bacterial contamination of frequently touched OPD table surfaces with variety of potential pathogens like Staphylococcus, Acinetobacter, Pseudomonas, Klebsiella, and E. coli was detected. Hand hygiene among health-care workers and regular and frequent cleaning and disinfection of OPD table surfaces are highly recommended to prevent cross-transmission.

Cardiac & Pulmonary Complications Seen in Liver Cirrhosis-An Observational Study at a Tertiary Care Hospital

INTRODUCTION: Cirrhosis is a condition that is defined histopathologically and has a variety of clinical manifestations and complications, some of which can be life-threatening. Patients with cirrhosis and portal hypertension exhibit characteristic cardiovascular & pulmonary hemodynamic changes. The cardiovascular complications include systolic dysfunction, diastolic dysfunction & electrochemical abnormalities like prolonged QT interval in Electrocardiogram (ECG), and Respiratory complications include Consolidation, Pleural Effusion & Pulmonary Arterial Hypertension, which may be due to Hepatopulmonary or Portopulmonary syndrome STUDY DESIGN: A two-year prospective observational study was conducted from July,2014 to June 2016 AIM: To study the different cardiac and pulmonary complications in the patients of Liver Cirrhosis. MATERIALS & METHODS: A two-year prospective observational study was conducted from July,2014 to June 2016 at a tertiary care hospital in Ahmedabad, Gujarat, India, including 30 patients (>12 years old), who were known cases of cirrhosis of liver as well as those newly diagnosed with it, with cardiopulmonary complications, developed after liver cirrhosis, in the absence of other etiological factors. Clinical profile with laboratory studies and diagnostic tests were studied. RESULTS: This study showed that cardiopulmonary complications in cirrhotic patients are more frequently seen in males than females, which commonly manifest during third & fourth decade. Dyspnoea is the most common symptom seen in the study. Among the pulmonary complications, Pneumonia & Hydrothorax are more common compared to hepatopulmonary & portopulmonary syndromes, and among cardiac complications, Diastolic dysfunction is a major complication in such patients, which increases with increasing severity of cirrhosis, as indicated by CP score. CONCLUSION: Among these patients, Cardiac and pulmonary complications have nearly the same incidences.

Histopathological study of malignant lesions of oral cavity

Background: Oral cancer is a heterogeneous group of cancers arising from different parts of the oral cavity, with different predisposing factors, prevalence, and treatment outcomes. It is the sixth most common cancer reported globally with an annual incidence of over 300,000 cases, of which 62% arise in developing countries. In comparison with the US population, where oral cavity cancer represents only about 3% of malignancies, it accounts for over 30% of all cancers in India, posing a significant challenge to health services by both preventive and diagnostic means. Incidence of oral cancer in India continues to rise and accounts for 50-70% of total cancer mortality. Objectives: (i) To study histopathology of malignant lesions of oral cavity, (ii) to study malignant lesions of oral cavity in relation to age, sex, and site, (iii) to compare observed findings with the similar studies done by other authors. Materials and Methods: This study was carried out in Department of Pathology, at a tertiary care hospital in Ahmedabad for the duration of 18 months, from January 2014 to June 2015. As a part of this study, 477 specimens of lesions of oral cavity were studied with main focus on histopathology of the lesion and keeping the following features in mind: age, sex, and site of lesion. Results: During the study, there were 477 cases of lesions of oral cavity. Among the malignant lesions of oral cavity, squamous cell carcinoma (SCC) was the most common finding and most common site affected by malignant lesions was buccal mucosa (BM). Most common age group affected by malignant lesions was 31-40 years (28%) with male:female ratio of 2.57:1. Incidence of SCC was 90.67%. Among the SCC, moderately differentiated SCC was most common grading. Most common age group affected by SCC was 31-40 years (27.94%) and 41-50 years (23.53%). Out of 68 cases of SCC, 50 (73.5%) were male and 18 (26.5%) were female with male:female ratio of 2.77. Most common site affected by the SCC was BM (41.18%) followed by tongue (39.71%) in the present study. Conclusion: Our study has revealed that SCC was the most common malignant lesions seen in oral cavity and moderately differentiated SCC was the predominant tumor type. Most common age group affected by malignant lesions was 31-40 years (28%) with male:female ratio of 2.57:1 and most common site involved was BM. The possibility of lymph node metastasis from oral SCC can be predicted with the help of certain factors such as site, size, and histological differentiation of the tumor. Hence, the study of site and differentiation is important.