Tertiary Care Hospital In Chennai Research Articles

Role of blood urea nitrogen to creatinine ratio in the assessment of hypovolemia who have undergone major surgeries- a cross-sectional study

BackgroundMajor surgeries are being carried for certain ailments. Surgeries can be major or minor depending on the extent of intervention. Major surgeries are prone to cause lots of complications such as shock, haemorrhage, wound infection, deep vein thrombosis, pulmonary complications, organ rejection, reactions to anaesthetics etc. Early identification of complications could reduce morbidity and mortality. Laboratory variables used in the assessment of hypovolemia include blood urea nitrogen, sodium, osmolality, hematocrit, and arterial blood gas. This study was undertaken to assess the utility of blood urea nitrogen: creatinine ratio (BCR) in the utility of assessment of hypovolemia in the first post-operative day in individuals who had major surgeries.Methods and materialsThe retrospective cross-sectional study included participants from the Departments of Orthopedic Surgery, Obstetrics and Gynecology, General Surgery and Cardiothoracic Surgery. Patients who underwent major surgeries between January 2019 and January 2020 were included. Study participants of 30 to 60 years of both genders were recruited into the study. Data were collected from the Medical Records of a tertiary care hospital in Chennai, India. Ethics approval was obtained, the institutional ethics committee (Ref: CSP/21/SEP/99/479 dated 30–12-2021). Waiver of consent was obtained since the patients were treated and discharged from the hospital. The data were analyzed by SPSS version 16. P value ≤ 0.05 was taken to be significant.ResultsBCR showed statistically significant difference across the groups with P = 0.02. BCR showed statistically significant difference between cardiac patients with total knee replacement and total abdominal hysterectomy surgeries. BCR showed positive correlation with age, fluids intake and negative correlation with pulse rate and respiratory rate.ConclusionBCR is a simple diagnostic tool for identifying hypovolemia in individuals who undergo major surgeries especially in the first postoperative day. It is significantly altered across the groups with highest value in individuals who have undergone knee replacement surgeries. BCR has high specificity and positive predictive value.

Increased parvovirus B19 seropositivity in healthy blood donors in India

A core component of every blood program is the supply of safe blood and blood products. The elevated risk of transmission through these products is due to parvovirus B19 (B19V) resistance to the virus inactivation procedures. Our study aimed to screen asymptomatic blood donors for B19V at a tertiary care hospital in Chennai, Tamil Nadu, between September 2020 and June 2021. Sera from 106 healthy blood donors who tested negative for Human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV), syphilis, and malaria were tested for anti-B19V IgM and IgG using a qualitative indirect enzyme-linked immunosorbent assay (ELISA). In the study population, 23.5% (n = 25) of donors tested IgM positive, 38.6% (n = 41) tested IgG positive, and 7.5% (n = 8) tested positive for both IgM and IgG. A proportion of 61.3% (n = 65) of the blood donors tested IgG negative, suggesting they had no past B19V infection. B19V DNA was not detected in any of the subjects. The high seroprevalence of IgM indicates that blood donors may have been recently exposed to B19V, potentially posing a risk to immunocompromised individuals and those with hematological stress. Further longitudinal studies with a larger sample size are recommended to better understand the risk of B19V transfusion transmission.

Assessment of Knowledge and Attitude of Asthmatic Patients and Their Caregivers Regarding the Disease Using an Asthma Knowledge Questionnaire in a Tertiary Care Hospital in Chennai.

Introduction Asthma, a significant non-communicable disease impacting all age groups, leads to productivity loss, particularly affecting children and causing disruption within families. This study aims to evaluate the knowledge and attitudes of asthmatic patients and caregivers through questionnaires, focusing on available treatment options. Aims and objectives The study aimed to assess the knowledge and attitudes of asthmatic patients and caregivers at a tertiary care hospital in Chennai, Tamil Nadu, India. Objectives included evaluating asthma knowledge using a questionnaire and assessing attitudes towards the disease and available treatment options. Materials and methods This cross-sectional study, conducted at the Department of Respiratory Medicine, Sree Balaji Medical College & Hospital, Chennai, focused on bronchial asthma patients and their caregivers in the Outpatient Department (OPD) from May 2021 to November 2022. The study included 150 participants selected randomly based on sample size calculations. Data, collected through a proforma, included demographic variables. Participants' knowledge and attitudes toward asthma were assessed using the Asthma Knowledge and Asthma Attitude questionnaires. Exclusion criteria comprised patients with a history of tuberculosis, chronic obstructive pulmonary disease, interstitial lung disease, recent hemoptysis, or evidence of infective exacerbation. Results and discussion Among 150 participants, 44% were females and 56% were males. Asthma knowledge was present in 62.1% of females and 79.8% of males, while 37.9% of females and 20.2% of males lacked understanding. High prevalence rates of breathlessness (89.4% females, 90.5% males), wheezing (92.4% females, 81% males), and cough (77.3% females, 75% males) were noted. The knowledge questionnaire revealed a mean score of 4 out of 8, indicating a moderate understanding with significant gaps. Many lacked knowledge about affected sites, harbored misconceptions about pet contact, and dust exposure, and were uninformed about triggers, symptoms, and treatment. Lack of awareness regarding weather-related exacerbations, smoking effects, and medication purposes was evident. Reluctance towards long-term inhaler use underscored the necessity for comprehensive asthma education among patients and caregivers. Attitude questionnaire scores varied: 17 scored 16, 37 scored 18, 24 scored 19, 35 scored 21, 20 scored 24, and 17 scored 26, averaging 20.6, reflecting generally positive attitudes. The attitude questionnaire, with six questions, highlighted attitudes toward asthma. However, stigma around asthma affecting normal lives (77.3%), fear of lifelong medication use (84%), and embarrassment over public inhaler use (74%) highlighted areas for attitude improvement to enhance therapy compliance and patient outcomes. Conclusion Our study highlights concerns among asthma patients and caregivers, particularly those with limited education, regarding treatment side effects. Issues include apprehensions about inhaler therapy's addictive potential, insufficient awareness of asthma triggers, improper inhaler techniques, reluctance towards long-term inhaler use, and embarrassment over public use of inhalers contributing to the study's complexities.

Analysis of Blood Donor Deferral Pattern at a Tertiary Care Hospital in Chennai: A Cross-Sectional Retrospective Study.

Background Blood is essential for saving lives, particularly in emergencies. However, many patients, especially in developing countries face delays in accessing safe blood due to inadequate infrastructure, insufficient blood banks, poorly equipped laboratories, unreliable transportation systems, low donation rates driven by cultural beliefs, fear, and misconceptions, poor blood donor recruitment and retention, economic constraints, and a general lack of awareness and education about blood donation. Ensuring safe transfusions requires advanced technology and promoting healthy, voluntary donations. Donor selection is crucial for safety, preventing adverse reactions through proper criteria and infection screenings. Donor deferrals can discourage donors and hinder recruitment, so identifying and addressing deferral causes is vital. Blood centers must balance quality and quantity by using thorough donor assessments. Efforts should focus on both recruiting new donors and retaining deferred ones to ensure a stable blood supply. Aim The aim of the study is to evaluate and analyze the patterns and causes of blood donor deferrals in a tertiary care hospital. The objectives are to determine the incidence and reasons for blood donor deferrals. Materials and methods A cross-sectional retrospective study was conducted for 36 months fromMay 2021 to May 2024.A simple random sampling method was used to select the blood donors who reported for donation. Data was obtained from records maintained by the blood center. Descriptive statistics were utilized to summarize the demographics of the blood donors, including deferral rates among males and females, and the frequency of temporary and permanent deferrals. A Chi-square test was done to find the association between gender and deferral rates in blood donation. This analysis aimed to explore gender variations and underlying health status differences between male and female donors, as these can influence deferral rates. Results From May 2021 to May 2024, 17,082 people registered to donate blood at the Blood Centre, Department of Transfusion Medicine. Out of these, 1,000 donors, or 5.85%, were deferred. The majority of donors were males 16,638, with only 444 females. Most deferrals (76.4%) were temporary, often due to low hemoglobin levels or recent alcohol intake. Permanent deferrals (23.6%) were usually due to uncontrolled hypertension and diabetes. A significant association was found between gender and type of deferral among participants (p < 0.05). Conclusion This cross-sectional retrospective study on blood donor deferral patterns in a tertiary care hospital highlights key reasons such as low hemoglobin, recent alcohol intake, hypertension, and diabetes. To improve donor eligibility and retention, targeted strategies including enhanced education and community engagement are essential. These efforts will strengthen blood transfusion services and support critical healthcare needs effectively.

Exploration and Evaluation of Adverse Drug Reactions Documented in a Tertiary-Care Hospital in Chennai: An In-Depth Retrospective Observational Study.

While drugs are intended to benefit patients, adverse drug reactions (ADRs) represent a significant negative outcome of drug consumption. They rank as the sixth leading cause of death among hospitalized patients. Many harmful effects are preventable and can reduce morbidity, mortality, and hospitalization duration. This study is a valuable resource for physicians, aiding in the safe and optimal use of medications. This retrospective observational study, conducted at the Pharmacovigilance Center of Saveetha Medical College and Hospital, Chennai, India, received approval from the Institutional Ethics Committee. All adverse drug interactions reported in our hospital from January 2019 to February 2024 were included after screening for inclusion and exclusion criteria. The collected reactions were analyzed, assessed, and evaluated between February 2024 and April 2024. Data on the drugs causing adverse reactions, the types of reactions, and the treatments administered were collected and documented. The reactions were categorized using the Rawlins and Thompson classification, while causality and severity were assessed using the standard Naranjo causality and modified Hartwigand Siegel severity assessment scales. During the study, 252 ADRswere documented by the Central Drugs Standard Control Organization. The gender distribution showed 123 cases (48.8%) in males and 129 cases (51.2%) in females, with a higher prevalence in the 20-40 age group. The departmentwise distribution revealed the highest number of ADRs in Obstetrics and Gynecology (60 cases, 24%), followed by General Surgery (52 cases, 21%), General Medicine (44 cases, 17%), Pediatrics (22 cases, 9%), and Emergency Medicine (20 cases, 8%). Antimicrobial drugs constituted the majority of ADRs (149 cases, 59.1%), followed by vitamins and mineral supplements (21 cases, 13.8%), contrast dye (15 cases, 6%), antituberculosis drugs (15 cases, 6%), analgesics (13 cases, 5.2%), and gastrointestinal (GIT) drugs (8 cases, 3.2%). Cefotaxime was the most commonly reported antibiotic (42 cases, 28.2%), followed by Ciprofloxacin (41 cases, 27.5%). Among vitamins and mineral supplements, iron sucrose was implicated in the highest number of ADRs (15 cases, 71.4%). The parenteral route of drug administration showed the highest incidence of ADRs (229 cases, 91%), followed by oral (20 cases, 8%) and topical routes (3 cases, 1%). Dermatological manifestations were most frequently reported (196 cases, 77.8%), followed by GIT symptoms (27 cases, 10.7%), and other manifestations such as shivering, fever, seizures, and dyspnea (29 cases, 11.5%). Based on the Naranjo causality assessment scale, 179 ADRs (71%) were categorized as probable, 55 (22%) as possible, 10 (4%) as certain, and 8 (3%) as doubtful. Approximately 47.2% of ADRs were self-limiting, while 44.1% required symptomatic treatment and 8.7% necessitated aggressive treatment, leading to a prolonged hospital stay or admission to the intensive care unit. The pattern of ADRs in our hospital aligns with findings from other studies. While many of these reactions are unpredictable and mild, they underscore the importance of raising awareness among clinicians and regulatory authorities to promote safe medication use and prevent potentially serious outcomes.

Prevalence of Bacterial Vaginosis and Its Association With Preterm Birth in a Tertiary Care Hospital in Chennai: A Cross-Sectional Study.

Background The most common preventive cause of premature labour is ascending infections.This study was conducted to evaluate the association between bacterial vaginosis (BV) and preterm labour in antenatal women and determine the significance of using the Amsel criteria to screen for BV. Methods This was a hospital-based cross-sectional study conducted among 100 antenatal mothers in the second trimester attending the antenatal OPD at a tertiary care hospital in Chennai from October 2019 to September 2021 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Data were entered in Excel (Microsoft Corporation, Redmond, WA) and analysed in SPSS (IBM Corp., Armonk, NY). Results According to the Amsel criteria, BV was detected in 21 women (21%). Neither maternal age nor parity had an effect on the study group. There was a statistically significant relationship (p < 0.05) between the mode of delivery, preterm labour, and the study group. Of the 21 positive BV cases, 95% were positive for clue cells and only 5% were positive for gram-negative bacteria. Consequently, BV was found to be associated with early labour. There is no association between BMI and BV (p > 0.005). Conclusion In the current study, BV was shown to be associated with preterm labour. Our study underscores the significance of the Amsel criteria as a valuable tool for screening BV in antenatal women.

Prevalence of Drooling among 5–10 Year-old Cerebral Palsy Children in Chennai: A Cross-sectional Study

Aim: The present study assessed the drooling among 5–10 year-old cerebral palsy (CP) children in a tertiary care hospital in Chennai and measured the drooling frequency and severity among them. Materials and Methods: Drooling was measured both quantitative and qualitatively. The drooling frequency score was recorded using the 5 min Drooling Quotient (DQ5) Scale. Children with CP were assessed for drooling under two different conditions (active and rest) totally for 10 min. The drooling assessment was done using the Thomas-Stonell and Greenberg classification. The severity of drooling was recorded as (1) dry - never drools, (2) mild - only lips wet, (3) moderate - wet on lips and chin, (4) severe - drools to the extent that clothing becomes damp, and (5) profuse - clothing, hands, tray, and objects become wet. The frequency of the drooling is recorded as (1) never drools, (2) occasionally drools, (3) frequently drools, and (4) constantly drools. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version. Results: A total population of 110 children were included in the study. Among the 110 patients, 82 (74.5%) were males and 28 (25.5%) were females with a mean age of 7 years ± 1 year and 9 months. The prevalence of drooling among the CP children in this study was found to be 94.5% (104 children). The average DQ score for males during rest was 55.5 and during activity was 55.87. For females, the average DQ score for males during rest was 55.5 and activity 56.18. A significant negative correlation exists between age and drooling frequency and drooling severity too. Conclusion: The present study demonstrated a significant association between drooling and age.

EVALUATION OF INCOMPATIBLE CROSSMATCHES AT A TERTIARY CARE HOSPITAL IN CHENNAI – A PROSPECTIVE STUDY

Objectives: The primary goal in blood transfusion is that the transfused blood unit be compatible with the patient during crossmatching. This compatibility testing is performed before every administration of blood component. This cross-matching test helps to detect the presence of antibodies in the recipient against antigens over red blood cells of donor. The aim of this study was to evaluate the incidence and causes of in compatible crossmatches in patients by tube agglutination method. Methods: This was a retrospective cross-sectional study conducted by analyzing incompatible crossmatches encountered during routine compatibility testing between January and December 2021 at the Department of Transfusion Medicine, Government Kilpauk Medical College and Hospital, Chennai, Tamil Nadu, India. The analysis was done in March and April 2022. All crossmatches were done by tube agglutination technique. Data were entered in Microsoft Excel and analyzed. Descriptive statistics were given in summary statistics. Results: Out of the total of 12943 crossmatches performed, 0.3% (n=39/12943) were incompatible. About 76.9% (n=30/39) were seen in females while 69.2% (n=27/39) were seen in the age group 20–60 years. About 35.9% (n=14/39) of the incompatible crossmatches were due to autoimmune hemolytic anemia (AIHA). A root cause analysis protocol was formulated to resolve the incompatibility and ensure safe transfusion. Conclusion: AIHA was the most common cause of incompatible crossmatch. The root cause analysis protocol involves a thorough evaluation of the patient’s clinical condition, underlying pathology, and errors during technical procedure to identify the cause of incompatibility. Protocols should be developed in each blood center and a logical stepwise approach will enable the provision of safe transfusion.

Effectiveness and usage of written and verbal counselling information on anxiety in MRI at a tertiary care hospital in Chennai

Background: Many people have considerable anxiety when having magnetic resonance imaging (MRI). Fear during an MRI causes the process to drag on longer and the quality of the images to decline, which increases expenses and requires labor loss. Objective: This study sought to determine how vocal and written information affected patients' anxiety during MRI procedures. Materials and Methods: A prospective cross-sectional study with 300 participants was conducted. The investigation occurred in March and April of 2022 at the tertiary care hospital's radiology department. Three participant groups were formed: group 1 received textual material, group 2 served as the control group, and so on; and group 3 learned about counseling. The State-Trait Anxiety Inventory (STAI), a measure of anxiety levels, was used to determine the people's traits and state of anxiety. Results: The three groups' trait anxiety scores did not significantly differ (p = 0.20) from each other's demographic features. Statistically speaking, group 3's state anxiety levels were lower than those of group 2 and the control group. Group 2's state anxiety levels were statistically lower (p&amp;lt;0.001) than those of the control group. Conclusion:Verbal and written information can help to lessen MRI anxiety. Written information may not be as good at lowering MRI anxiety as verbal information.

Association Between Serum Ferritin and the Duration of Type 2 Diabetes Mellitus in a Tertiary Care Hospital in Chennai.

Hyperinsulinemia has been linked to increased ferritin production and iron absorption in type 2 diabetes mellitus, ultimately leading to increased iron storage. Glucose intolerance is intimately linked to this issue. Increased oxidative stress from iron decreases insulin's ability to be taken into cells and used for energy. Researchers suggest that increased iron levels in the body play a role in the emergence of insulin resistance, glucose intolerance, and vascular repercussions associated with diabetes. The aim of this study is to assess the levels of serum ferritin and fasting plasma glucose in both diabetic and nondiabetic individuals while establishing a relationship between the two. Exploring the connection between serum ferritin levels and the duration of diabetes mellitus in individuals diagnosed with diabetes is our objective. In this study, 80 men diagnosed with type 2 diabetes mellitus were included, and they were compared with 70 male volunteers who were in good health. We took blood samples while the subjects fasted, and we analyzed the plasma glucose and serum ferritin levels. In the diabetic group, there were notably higher levels of serum ferritin and fasting plasma glucose compared to the nondiabetic subjects. Furthermore, a correlation was observed between the duration of diabetes among participants with diabetes and elevated serum ferritin levels. The findings suggest that low-grade inflammation and increased body iron stores are positively related to hyperglycemia in type 2 diabetes mellitus.

Perception and Practices Related to Breast Milk Donation and Acceptance among Donor and Recipient’s Mothers of a Breast Milk Bank at a Tertiary Care Hospital in South India

Background: Human Milk Banks (HMB) ensure the availability of pasteurized donor breast milk for small forgestational age babies, low birth weight infants, sick new born and infants of mothers with failed lactation.Objectives: To assess the perception, practices and associated factors of breast milk donation and acceptanceamong donor and recipient’s mothers registered with the breast milk bank.Methodology: This hospital based cross-sectional study was conducted between July to September 2019 among70 donors and 70 beneficiaries who were mothers of children under 6 months of age, registered at the breast milkbank at a tertiary care hospital in Chennai. Data was collected by interview of the mothers with a predesignedsemi-structured questionnaire.Results: Only 74% of them were aware of breast milk bank services. Almost 47 (67.1%) had received more thantwice from breast milk bank. Proportion of recipient’s mothers who had complications during their delivery andproportion of children who were treated in NICU were significantly higher among the recipients (p &lt; 0.001).Conclusion: Awareness on breast milk bank services is required especially among the mothers of prematurebabies, low birthweight neonates, and newborn receiving treatment in NICU.

Knowledge and awareness about biomedical waste segregation and disposal among medical and paramedical students at a tertiary care hospital in Chennai

Abstract Introduction: Wastes produced by health-care facilities are unique in terms of generation, composition, treatment, and disposal when compared to other general wastes. Inappropriate handling of biomedical waste (BMW) led to several health risks from sharps injuries, the spread of infections, and the release of toxic substances into the environment. Not many studies throw insight into the difference in knowledge, attitude, and practice (KAP) across medical and paramedical students related to BMW segregation and disposal. This cross-sectional study aimed to assess the knowledge and awareness levels regarding BMW segregation and disposal among medical and paramedical students at a tertiary care hospital in Chennai, India. Methods: A structured questionnaire was administered to a sample of 632 participants, including medical (3rd and 4th years) and paramedical students. The questionnaire assessed their KAP related to BMW management. Descriptive statistics were used to analyze the data, and a comparison was made between medical and paramedical students using appropriate statistical tests. Results: The results revealed that medical students (3rd and 4th years) exhibited better KAP in BMW management than paramedical students. Medical students demonstrated a more comprehensive understanding of BMW segregation, disposal methods, and associated health risks. They also displayed a higher level of awareness regarding the importance of proper BMW management for environmental and public health protection. Conclusion: Our findings emphasize the need to strengthen educational interventions targeting paramedical students to enhance their understanding of proper BMW management practices.

Physical Activity, Functional Status, and Quality of Life Among Older Adults in India.

Physical activity and social engagement protect older adults against functional decline and improve their quality of life. Physical inactivity poses an increased risk for noncommunicable diseases. Globally, one in four adults is physically inactive. Enhancing the physical activity of older adults is crucial not only for increasing their life expectancy but also for improving their functional status and quality of life. This study aimed to evaluate the physical activity, functional status, and quality of life of older adults attending the medical outpatient department of a tertiary care hospital in Chennai, Tamil Nadu, India. The study adopted a descriptive cross-sectional research design. A total of 100 female and male patients above 65 years of age with comorbid conditions attending the medical outpatient department participated in the study. The sociodemographic and clinical characteristics of these patients were assessed. In addition, the Rapid Assessment of Physical Activity, Katz Index of Independence in Activities of Daily Living, Lawton Instrumental Activities of Daily Living Scale, and Older People Quality of Life Questionnaire were used to measure the physical activity, functional status, and quality of life of patients. The data were analyzed using descriptive and inferential statistics. Among the participants, only 17% were active, and 35% were underactive for regular light activities. Approximately 81% did not perform any activity to improve their muscle strength or flexibility. In 56% of the participants, disability was present. The majority mentioned that they experienced difficulties in preparing food and shopping. Regarding the quality of life of the participants, the mean ± standard deviation score was 77.38 ± 9.03. Significant results were found in the domains of independence, control over life, and freedom. The overall quality of life was not related to leisure and activities, financial circumstances, the Instrumental Activities of Daily Living Scale score, the Rapid Assessment of Physical Activity 2 score, and the Rapid Assessment of Physical Activity 1 score. The quality of life was weakly related to emotional and psychological well-being, control over life, home and neighborhood, freedom, independence, and social relationships. Limited physical activity and poor functional status impact the quality of life of older adults. Therefore, educational and physical interventions should be implemented at the hospital and community levels to improve the physical activity, functional status, and quality of life of older adults.

Validity and performance of cognitive scales in elderly patients with depression in a tertiary care hospital in Chennai

Background: Late-life depression in older adults can cause reversible cognitive impairment, often resulting in pseudo-dementia. Cognitive impairment can lead to executive dysfunction, reduced flexibility, and difficulty thinking and decision-making. This study aimed to assess the validity and performance of cognitive scales in late-life depression among patients attending the outpatient department of the institute of mental health, Chennai. Methods: This prospective study included 360 patients aged &gt;50 years who were diagnosed with depression and attended the OPD at the institute of mental health, Chennai. Baseline assessments were performed at the time of recruitment into the study (visit 1), and scheduled visits were performed every six months for two years (visits 2 to 5). Unscheduled visits were done every month, and adverse events were monitored and recorded periodically Results: Among 59 patients, 53.1% were female, 32.2% were diabetic, and 93.9% were experiencing subjective working difficulties. The Montreal cognitive assessment scale classified 51.4% as moderate, while the ADAS-cog and ACE scales classified 86% and 99.7%, respectively, as having abnormal mental status. However, a significant correlation and discrepancy between scores were observed for scales such as ACE, ADAS-cog, standardised mini-mental status examination, and Montreal cognitive assessment scale. A strong correlation was found between ACE, MMSE, MoCA, and ACE; however, FAST showed a significant negative correlation. The MoCA was strongly correlated with the MMSE, ACE, ADAS-cog, and Mini-Cog, indicating good alignment with the FAST. Conclusions: Cognitive scales strongly correlate with late-life depression in patients, suggesting an improvement in assessment, evaluation, and treatment to address cognitive deficits.

Clinicodemographic profile and treatment outcomes of COVID-19 patients admitted in a designated tertiary care hospital, Chennai: A comparative analysis of first and second wave of the pandemic

Background: COVID-19 caused by severe acute respiratory syndrome (SARS)-COV 2 virus was declared a pandemic by the WHO in March 2020. India has reported 44,689,512 cases and 530,779 deaths as of March 9, 2023. Different variants may lead to varying clinical presentations and outcomes, emphasizing the need for ongoing analysis of local COVID-19 patients. Aims and Objectives: To describe the clinic-demographic profile and treatment outcomes of COVID-19 patients in a tertiary care hospital in Chennai and to compare the patient characteristics during the first two waves of the pandemic in India. Materials and Methods: A retrospective record-based study analyzed patients with SARS-CoV-2 between May 2020 and July 2021, collecting data on demographics, travel history, symptoms, hospital stay, and outcome. Data were analyzed using SPSS Version 20.0. Chi-square test and Fisher exact tests were used to ascertain significant association between variables. Results: Out of 944 cases of COVID-19, 70% were aged 20–60 years with a male predominance in both waves. The mean age during the first wave was 45.04±17.32 and during the second wave was 45.86±15.49. Intensive care and ventilatory support needs increased in the second wave. Hospital stay was longer during the first wave. Death rates were 3% and 14% in the first and second waves, respectively. Conclusion: In our study, community transmission was observed as most COVID patients did not have travel history. Males, elderly and those with comorbidities were heavily impacted. The second wave had higher ICU and mortality rates.

Association of Asthma With Patients Diagnosed With Metabolic Syndrome: A Cohort Study in a Tertiary Care Hospital.

Introduction Asthma is defined as a chronic inflammatory airway disease. The prevalence of both asthma and obesity has been rising simultaneously, demonstrating a parallel trend. Obesity is a significant factor in metabolic syndrome, and numerous studies have indicated a connection between metabolic syndrome and bronchial asthma. Aims and objectives The aim of this paper is to evaluate the association of asthma with patients diagnosed with metabolic syndrome. The main objectives were to analyze the clinical profile and spirometric indices in patients with metabolic syndrome and to assess asthmatic patients among them with spirometry and clinical parameters at a tertiary care hospital in Chennai. Materials and methods This hospital-based cohort study was conducted on 73 patients attending the outpatient department who had a known case of metabolic syndrome and were evaluated for asthma through history, physical examination, and a pulmonary function test. A history of cough, expectoration, shortness of breath, wheezing, chest tightness, allergy, seasonal variation, and smoking habits was asked, and a thorough physical examination was performed. Bronchial asthma was confirmed with airflow reversibility by spirometry as per the Global Initiative for Asthma Guidelines. Metabolic and spirometry parameters were examined, such as body mass index (BMI), waist circumference, waist-hip ratio, fasting blood sugar (FBS), postprandial blood sugar, hemoglobin A1C (HbA1C), serum insulin, lipid profile, C-reactive protein (CRP), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and FEV1/FVC pre- and post-reversibility (baseline vs. six months). Results and discussion The average BMI of all participants was 29.6511 ±2.64564. The waist-hip ratio was 0.5512 ±0.43855, which decreased during the follow-ups, demonstrating a decline in the risk of obesity in study participants. The level of HbA1C showed a drop from 6.1% to 5.9% at the first follow-up. This exhibited a further reduction at the six-month follow-up in addition to a positive reflection in insulin sensitivity, indicating successful control of diabetes among study participants. It was discovered that this was statistically significant (p<0.001). At the third and sixth months of follow-up, the FEV1/FVC ratio increased by 38% and 37%, respectively, when metabolic syndrome was under control. The results show that controlling diabetes, hypertension, obesity, and triglyceride values improved asthmatic symptoms, and this was determined to be statistically significant (p<0.001). Conclusion The results of the current study demonstrated that the regulation and maintenance of metabolic parameters such as BMI, diabetes, hyperlipidemia, and hypertension aid in improving asthma control.

Prevalence of Dermatophyteic Infection in A Tertiary Care Hospital in Chennai in India

Dermatophytes are fungi that infect keratinized tissues in animals and humans. The group's most prevalent and only anthropophilic species is Trichophyton rubrum, whereas species from the Trichophyton mentagrophytes complex are zoophilic and anthropophilic. The prevalence of dermatophyte infections varies depending on environmental factors and location, with higher rates observed in tropical countries like India. Hence, this study was conducted to comprehend the distribution of various species and clinical symptoms to assess the prevalence and features of dermatophyte infections in patients receiving tertiary care. This study's main objective was to identify the frequency of dermatophyte species in clinical samples taken from suspected patients in a tertiary care centre.1000 patients attending Sree Balaji Medical College in Chennai were the subjects of cross-sectional observational research. The prevalence of dermatophyte infection was assessed using clinical sample data. The analysis included information on gender, age group, and clinical symptoms. In the examined samples, dermatophyte infection was shown to be clinically prevalent (14.2%). More men (64.7%) than women (35.2%) were impacted. The most common age group for dermatophyteic infection was those between 31 and 40 years. The most typical clinical presentation was tinea corporis, characterized by scaly, red areas on the skin. The most frequent dermatophyte species found was Trichophyton rubrum. The study revealed that the clinical samples taken from the tertiary care centre had a significant prevalence of dermatophyteic infection. These infections were more likely to affect men and those in the age range of 31 to 40 years. The most commonly noticed clinical sign was tinea corporis, caused by Trichophyton rubrum. These findings emphasize the need to detect and treat dermatophyteic infections, particularly tinea corporis, highlighting the need for suitable treatment techniques in the population under study.

Incidence and risk factors of Retinopathy of Prematurity – a prospective observational study

Objective Retinopathy of Prematurity (ROP) is a vasoproliferative retinopathy that affects the developing retinal vessels of premature infants. Identification of risk factors is essential for its early detection and intervention. The study was aimed to assess the incidence of ROP and to determine the risk factors associated with ROP. Methods It was a prospective observational study which included preterm neonates admitted in neonatal intensive care unit of a tertiary care hospital in Chennai,Tamil nadu,India from December 2020 to September 2021. Screening for ROP was performed for all neonates below 34 weeks gestation and between 34 to 36 weeks with risk factors for ROP. Association between risk factors and ROP was determined using chi square test for categorical variables and students t test for continuous variables. A p value less than 0.05 was considered significant. Results Of the 140 neonates screened, 45(32.1%) neonates were diagnosed to have ROP. Among the neonates detected to have ROP there were 24(53.3%) male. 34(75.6%) neonates had a birth weight less than 1.75 kg, 27(60%) neonates had a gestational age less than 34 weeks,22 (48.9%)neonates were born to primi mothers, 25(55.6%) neonates were delivered by normal vaginal delivery. Among the neonatal risk factors studied, sepsis was found to have a significant association with ROP (p=0.02). ). Risk factors like apnoea, respiratory distress syndrome, intraventricular hemorrhage, oxygen therapy and blood transfusion did not have a significant association with ROP. Conclusion The present study revealed an incidence of ROP of 32% and there was significant association with sepsis.

Seroprevalence of Hepatitis C Virus Infection among Hemodialysis Patients in A Tertiary Care Hospital in South India

Hepatitis C virus (HCV) infection in hemodialysis patients is mainly associated with insufficient precautionary measures. Compared with the general population, the prevalence of HCV infection is high among hemodialysis patients. HCV infection in these patients is typically associated with increased morbidity and mortality; however, the early detection of HCV may retard disease progression and reduce morbidity and mortality. In this study, we sought to estimate the seroprevalence of HCV infection among patients undergoing hemodialysis in a tertiary care hospital in Chennai, Tamil Nadu, South India. This was a prospective, observational, cross-sectional study that included 82 hemodialysis patients. Blood samples were collected from each patient, and the serum was separated for detection of the presence of HCV antibodies, HCV core antigen, and HCV RNA using an enzyme-linked immunosorbent assay, enzyme immunoassay, and polymerase chain reaction, respectively. Relevant socio-demographic, clinical, and laboratory information was also obtained. Among samples collected from the 82 patients, seven were found to be positive for HCV antibodies, whereas nine and eleven samples were found to be positive for HCV core antigen and HCV RNA, respectively. Long durations of renal failure and hemodialysis were identified as being positively associated with HCV infection in these hemodialysis patients, and a statistically significant reduction in hemoglobin levels and an increase in creatinine levels were detected among the HCV-positive patients. The overall seroprevalence of HCV infection in hemodialysis patients was found to be 13.4%. Given that high rate false-negative reactions were detected using ELISA and EIA, screening of HCV RNA during the early stages of HCV infection can contribute to preventing its nosocomial spread in these patients. Moreover, it is imperative that stringent universal precautionary measures are implemented in all health care settings and hemodialysis units to minimize the risk of HCV transmission.

Glycemia and New-Onset Diabetes among COVID-19 Patients with Prediabetes: A Follow-Study of Case Series in India

Studies have shown that COVID-19 patients with prediabetes frequently present with high plasma glucose levels on hospital admission. However, whether the glycemic abnormalities are temporary or persist after recovery from the illness is unclear. We conducted a follow-up study of the case series of 69 COVID-19 patients with prediabetes (HbA1c 5.7–6.4%) who were admitted to a tertiary care hospital in Chennai, India, from May to October 2020 and were discharged alive. Over a mean follow-up of 146.6 (SD: 72.5) days, the mean fasting plasma glucose rose significantly by 16.8 mg/dL (from 119.3–136.1 mg/dL), 2-hr post-prandial glucose by 61.0 mg/dL (from 176.2–237.2 mg/dL), and HbA1c by 0.6% (5.9–6.5%). Of the 49 (84.5%) patients who were discharged with glucose-lowering medications, 40 (81.6%) continued taking them at the first follow-up visit (mean of 50.1 days from admission), and 39 (79.6%) continued taking them at the second follow-up visit (mean of 114.3 days from the first follow-up visit). In addition, 12.1% of patients developed new-onset diabetes after recovery from the illness. These findings underscore the importance of regular monitoring of glycemic parameters in COVID-19 patients with prediabetes after recovery.