Tertiary Care Hospital In Jaipur Research Articles

Study on occurrence of Hepatitis B virus Genotypes at a tertiary care hospital in Jaipur

Study on occurrence of Hepatitis B virus Genotypes at a tertiary care hospital in Jaipur

Seroprevalence Study of Dengue at a Tertiary Care Hospital in Jaipur, Rajasthan

Background and Aim: Dengue is one of the most severe mosquito-borne viral infection. In the absence of specific treatments and vaccines for dengue fever (DF), vector control is the only method by which the spread of dengue can be prevented. This study investigates the seroprevalence of DF cases by detecting NS1 antigen and immunoglobulin (Ig)-G and IgM antibody by enzyme-linked immunosorbent assay (ELISA) test. Materials and Methods: This study was carried out in the Department of Microbiology, at a Tertiary Care Hospital, Jaipur (Rajasthan), done between 6 months. Blood samples from clinically suspected cases of dengue were tested immediately for qualitative detection of NS1 Ag, IgM, and IgG antibodies by ELISA. Results: One thousand seven hundred and sixty-three serum samples were tested for dengue NS1 antigen, IgM, and IgG, out of which 1066 were positive for one or more serological parameters. Dengue cases for the NS1 infection are 52.53%, for the IgM infection is 33.39%, and for the IgG infection is 14.07%. Sixty-two percentage positive samples were of male patients and 57% of positive samples were from 19 to 40 years of age group (adult population) (59%). The seasonal trend showed a gradual increase in dengue-positive cases that started in September with a peak in October (46.24%). Conclusion: The monsoon and postmonsoon seasons are times of high virus activity and enhanced vector breeding. The population must thus be constantly monitored to prevent the virus from spreading further, and serological tests are crucial for making an early diagnosis. ELISA is advised for all suspected dengue patients to initiate therapy and decrease the morbidity and fatality rate.

Sick Neonate Score as Predictor of Neonatal Mortality and Duration of Hospital Stay

Abstract Background: Sick neonate score (SNS) is a simple clinical score that requires minimal basic equipment and expertise. It is utilized for the prediction of mortality among neonates. Objective: The objective of this study was to study the correlation of SNS with mortality and duration of hospital stay of admitted neonates. Methodology: This hospital-based observational descriptive study was conducted in a tertiary care hospital in Jaipur, Rajasthan. A total of 404 outborn transported neonates were enrolled. Baseline characteristics and SNS were recorded and analyzed. Categorical data were presented in numbers and percentages, whereas continuous data in mean and standard deviation. The Chi-square test and unpaired t-test were used for analysis. Receiver operating characteristics curve analysis was used to estimate the cutoff value of SNS determining the mortality and duration of hospital stay of the patient. Results: Out of 404 neonates 243 (60%) were tachypneic, 242 (59%) had oxygen saturation <92% and 216 (53%) were hypothermic. A cutoff of SNS ≤8 with a sensitivity of 93% and specificity is 53.4% was found for prediction of mortality among neonates. A significantly higher number of patients with SNS score ≤8 had expired within 3 days. Among discharged patients, a significantly higher number of patients with SNS score ≤8 had a duration of stay in hospital >7 days. Conclusion: SNS has a good negative correlation with mortality. Neonate with SNS ≤8 either expired early or was discharged with a higher duration of hospital stay.

Effect of lockdown on routine immunization services in a tertiary care hospital of Rajasthan, India: quarterly analysis

Background: Lockdown was used as a tool to control COVID-19 but it has resulted in the disruption of routine immunization services both in India and globally. Present study aimed to estimate the effect of COVID-19 lockdown periods during years 2020 and 2021 on routine immunization at tertiary-care hospital in Jaipur, Rajasthan, India. Methods: A retrospective record-based observational study was conducted at paediatric tertiary-care hospital, Jaipur. Data were collected from the immunization records of the centre for the vaccines administered to children (0-16 years) under the universal immunization programme (UIP) from January 2019 to December 2021. Doses administered were assessed as a proxy measure of vaccine coverage. The vaccination trends were compared with base year 2019. unpaired ‘t’ test of significance and percent change were used for statistical analysis. Results: The effect of lockdown was maximum in the second quarter of both years 2020 and 2021 with the declination of the total vaccine doses administered by -49.9% and -36.2% respectively. The first lockdown period in year 2020 recorded maximum negative difference in dose of Td (10 years) (-98.4%) followed by DPT booster-2 (-83.6%). The second lockdown in year 2021 recorded maximum negative difference in dose of Td (16 years) (-62.5%) followed by Td-10 years (-58.1%) and DPT booster-2 (-56.5%). Conclusions: This study concludes that the least vaccine doses were administered in second quarter of both years which coincides with lockdown period. Hence during emergencies like lockdown other alternative arrangement for continuance of routine immunization may be implemented.

AN OBSERVATIONAL STUDY TO ASSESS THE CLINICAL PROFILE AND OUTCOMES OF DIABETIC FOOT ULCER AT A TERTIARY CARE HOSPITAL IN JAIPUR

Background: Diabetes mellitus (DM) is one of the main problems in health systems and a global public health threat that has increased dramatically over the past 2 decades [2, 3]. According to epidemiological studies, the number of patients with DM is estimated to be more than 360 million people by 2030 [4, 5]. DFU is considered as a major source of morbidity and a leading cause of hospitalization in patients with diabetes. In view of this, the present study was undertaken to address the demographics, clinical prole, and outcomes of diabetic foot ulcer at a tertiary care hospital in Jaipur. A hospital based prospective observational study The mea Methods: Observations: n age of the study participants was found to be 56.33 + 12.637. 61.8% of the study participants were found to have pure neuropathic type of ulcer with 24.3% having neuro-ischemic type of ulcer. 13.9% of the study participants had pure ischemic type of ulcer. 37.5% of the study participants underwent wound debridement. 3.5% of the study participants underwent SSG,59% of the study participants underwent amputations. The mean HbA1c of the study participants was found to be 8.951 + 1.6008. The mean duration of stay at hospital of the study participants was found to be 5.73 + 2.025. Mortality of the study population was 3.5%. Majority of the patients underwent multiple toe amputations, there w Conclusion: as a signicant statistical association between the Wagner's grade and the mode of intervention performed, . Adequate glycaemic control, periodic screening for diabetic foot neuropathy, preventive foot care and education programs should be made available, particularly in primary and secondary health care settings to tackle the DFU disease which is a contributor to signicant morbidity among diabetics

Comparative Evaluation of Topical Betamethasone Dipropionate Lotion 0.05% versus its Combination with Intralesional Triamcinolone Acetonide Injection in Alopecia Areata: A Randomised Controlled Trial

Introduction: Alopecia Areata (AA) is non-cicatricial patchy hair loss, which is fairly common and may evoke feelings of vulnerability and loss of self-esteem in patients. Many different treatment modalities have been recommended, including topical, systemic, and intralesional corticosteroids (ILCs). However, no treatment has consistently produced satisfactory results, and various topical therapies used in the past have shown limited effectiveness. ILC is the most commonly used treatment for AA, especially in patients with <50% area involved. Despite this, there is a lack of adequately powered randomised controlled trials assessing the efficacy, safety, and duration of response. Aim: To compare the efficacy of intralesional triamcinolone acetonide injection, topical betamethasone dipropionate lotion 0.05%, and their combination in treating AA. Materials and Methods: This randomised controlled trial was conducted at the Department of Dermatology, SMS Medical College, a Tertiary Care Hospital in Jaipur, Rajasthan, India, over a one-year period from August 2012 to July 2013. The study included patients aged 11 to 50 years who were willing to provide informed consent. A total of 120 patients were randomised into two groups (Group A and Group B) of 60 patients each. Twenty patients did not follow up, leaving 53 patients in Group A and 47 patients in Group B who completed the study were 53 in group A and 47 in group B. Group A received topical betamethasone dipropionate lotion 0.05% with single-night application and intralesional triamcinolone acetonide 10 mg/mL at baseline, 4, 8, and 12 weeks. Group B received topical betamethasone dipropionate lotion 0.05% with single-night application and intralesional normal saline at the same intervals. Patients were followed up for an additional 12 weeks. Responses were evaluated using the Hair Regrowth Grade (HRG) scale, and statistical analysis was performed using the Chi-square test. Results: Among the study population, the majority of patients (49, 41%) were in the age group of 21-30 years, with 91 males and 29 females. At the end of the 12-week treatment and 12- week follow-up period, Group A showed greater improvement, with 62% of patients achieving hair regrowth grade scale S-IV (76-100%), and 87% {S-IV (76-100%)} respectively, as compared to only 13% in Group B. Similarly, in the follow-up period, Group A had a higher percentage of patients with S-IV (76-100%) regrowth (87%) compared to Group B (32%). Conclusion: This study concludes that intralesional triamcinolone acetonide 10 mg/mL is an effective and safe treatment option for AA. The addition of single-night application of betamethasone dipropionate 0.05% lotion yields better results than using either treatment alone.

Study of Natural Deaths in Custody at Tertiary Care Hospital in Rajasthan

As death is final outcome of life, it is inevitable in prisoners too. Pattern of deaths can reveal living conditions and practices in a population. This study was conducted to observe the pattern of natural deaths among prisoners autopsied at a tertiary care hospital in Jaipur during April 2017 to March 2018. During this period 16 cases of alleged natural deaths in custody were autopsied comprising of 15 males and 1 female. The natural deaths were almost evenly distributed in all age groups. Carcinoma was leading cause of death in (37.5%) cases, followed by cardio-vascular causes in (25%) cases, intracranial hemorrhage in (12.5%) cases, septicaemia in (12.5%) cases, tuberculosis associated with HIV in (6.25%) case and Pneumonia associated with Parkinsonism in (6.25%) cases. All (100%) of the natural deaths received medical attention prior to death and died in hospital. Injuries were present in 5 cases (31.25%) but were not attributed to causing deaths.

Clinical Profile of Healthcare Workers Affected by COVID-19 and its Outcome in a Tertiary Care Hospital in Jaipur, Rajasthan: An Observational Study

Clinical Profile of Healthcare Workers Affected by COVID-19 and its Outcome in a Tertiary Care Hospital in Jaipur, Rajasthan: An Observational Study

Circulating Dengue Serotypes and their Correlation with Severity of Disease at a Tertiary Care Hospital in Jaipur, Rajasthan

Circulating Dengue Serotypes and their Correlation with Severity of Disease at a Tertiary Care Hospital in Jaipur, Rajasthan

Case control study on the association between vitamin d deficiency and diabetes mellitus type 2 at tertiary care hospital, Jaipur

Introduction: Diabetes mellitus refers to a group of common metabolic disorders. Recently, emerging evidence has suggested a role for suboptimal vitamin D status in the etiology of T2DM. This study aimed to determine the association between Vitamin -D deficiency and type 2 Diabetes Mellitus in patients of tertiary care centre, Jaipur. Method and material: This was a hospital based descriptive type of observational study done in Department of Medicine, of a tertiary care hospital in Jaipur, Rajasthan. This study included 100 cases and 100 control. Result: There were 55% males and 45% female among study participants. Out of 200 participants, 160 (80%) subjects are vit D deficient in which 84 (42%) are cases and 76 (38%) are controls, means cases are more deficient for vit D in comparision to controls. Conclusion: Though vitamin D deficiency is prevalent in T2DM and non-diabetic control subjects, its relationship in glycation control or insulin resistance in T2DM subjects could not be confirmed in our study population. This is potentially an important finding for public health, demonstrating that improvement in vitamin D status is one of the factors responsible for better health of the individuals.

Detection and Prevalence of Inducible Clindamycin Resistance in Clinical Isolates of Staphylococcus aureus: Experience from Tertiary Care Hospital in Jaipur

Background: Staphylococcus aureus is a frequent cause of bacterial infections in both developed and developing countries. Emerging resistance to methicillin in this organism has left us with very few therapeutic alternatives to treat the infections caused by them. Objective: We aimed to determine the prevalence of inducible clindamycin resistance in clinical isolates of S. aureus and antimicrobial susceptibility pattern of S. aureus isolates due to the increasing prevalence of resistance to most antimicrobial agents in staphylococci signifies the need for new effective agents to treat staphylococcal infections. Methods: The study was carried out in the Department of Microbiology at Mahatma Gandhi Hospital, Sitapura, Jaipur, Rajasthan. All S. aureus isolates (non-repetitive) from different clinical samples received in clinical microbiology laboratory from in and outpatients in Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, were included in the study. Results: Out of 157 erythromycin-resistant S. aureus, 74 (47.133%) show MS phenotype, 48 (30.57%) show inducible clindamycin resistance, and 35 (22.29%) show constitutive resistance. All 48 S. aureus isolates which showed inducible clindamycin resistances (D-test positive) were further subjected to antimicrobial susceptibility testing.In the present study, 100% sensitivity was observed by vancomycin, linezolid and tigecycline, followed by tetracycline, 89.58% and gentamicin, 83.33% while 100% resistivity were observed by levofloxacin. Conclusion: We can conclude that there is high percentage of inducible clindamycin resistance among Staphylococcus isolates. If D-test would not have been performed, many inducible clindamycin-resistant S. aureus could have been easily misidentified as clindamycin susceptible, leading to therapeutic failure. Thus, simple and reliable D-test can be incorporated into routine in clinical microbiology laboratory.

Determination and Prevalence of Antinuclear Antibody (ANA) Patterns in Autoimmune Disorders in a Tertiary Care Hospital, Jaipur

Introduction: Autoimmunity is the immune response of antibodies against normal cellular components. With the advent of serological testing for autoimmune disorders, detection of anti-nuclear antibodies (ANA) by indirect immunofluorescence method became the gold standard. ANA screening is non-specific, reliable and a quick way and identifies immunofluorescent patterns linked to autoimmune disorders. Aim: This study was undertaken to identify the prevalence of ANA patterns amongst the various demo graph presented in a tertiary care hospital in Jaipur, Rajasthan. Material and Method: 100 serum samples were screened by indirect immunofluorescence microscopy in the duration of July 2021 to October 2021. Results: 27% of the serum samples presented with positive ANA patterns out of which 62.96% were nuclear speckled, followed by 22.22% of nuclear homogenous pattern and 7.40% were observed to be cytoplasmic speckled. The age bracket with higher positivity were 20-40 years (28%) and 40-60 (28%). There was female predominance noted in the ANA positivity. Conclusion: Nuclear speckled was the most frequent pattern, few unusual patterns were also observed. An observational study is needed to understand not only the epidemiology of autoimmune disorders but also the predictive value of ANA IIF in clinical setup, besides considering the possibility of taking up IIF as a screening tool for autoimmune disorders. Keywords: Antinuclear antibody (ANA), indirect immunofluorescence (IIF), systemic lupus erythematosus (SLE), autoantibody.

Prescribing patterns in type 2 diabetes mellitus outpatients at a tertiary care centre in Jaipur, India

Background: Over the last few years, an unexpected increase in the prevalence of diabetes in India have been witnessed. The present study was planned to analyse prescribing patterns of anti-hyperglycaemic drugs and assess the influence of Chief Minister's Free Drug Scheme in Rajasthan, India. It aimed to evaluate, monitor and if possible, suggest modifications in prescribing practices to make medical care rational and also to assist minimising adverse drug reactions (ADRs). Methods: This was a cross-sectional, observational study carried out for a 12-month period. A total 400 known patients of type 2 diabetes mellitus (T2DM) from endocrinology outdoor of SMS Medical College Hospital (a tertiary care hospital in Jaipur, Rajasthan, India) were recruited and their prescriptions were analysed using the World Health Organization (WHO) prescribing indicators. Results: Most commonly observed age group was of 40-50 years (mean age 53.76 ± 8.84), with a male preponderance (57.5 %). Among them, 67.5 % of patients were found to be obese (mean BMI 29.79 ± 3.26). All anti-hyperglycaemic were prescribed in their generic names only. Metformin was the most frequently prescribed anti-hyperglycaemic agent. Among the fixed dose combinations, the most common was that of glimepiride and metformin (40.75 %), while most prescribed add on anti-hyperglycaemic was teneligliptin (51.5 %), followed by pioglitazone (30.5 %). A total of 53.25 % of these patients received insulin along with oral anti-hyperglycaemic agents. Conclusion: The anti-hyperglycaemic agent prescribing among endocrinology outpatients at tertiary care hospital in Jaipur was found to be satisfactory.

Role of aminoglycosides in management of ventilator-associated pneumonia caused by Klebsiella pneumoniae: A report from a tertiary care hospital in Jaipur

Role of aminoglycosides in management of ventilator-associated pneumonia caused by Klebsiella pneumoniae: A report from a tertiary care hospital in Jaipur

Risk Factors for Candidemia in Intensive Care Unit: A Matched Case Control Study from North-Western India

Candidemia is one of the significant causes of mortality amongst critically ill patients in Intensive Care Units (ICUs). This study aimed to assess the incidence, risk factors and antifungal susceptibility pattern in candidemia cases admitted in ICU in a tertiary care hospital in Jaipur, Rajasthan from June 2021 to November 2021. Candida species isolated from blood culture of clinically suspected patients of sepsis were defined as candidemia cases. Blood culture and antifungal susceptibility testing were performed as per standard laboratory protocol. Analyses of risk factors was done between candidemia cases and matched controls in a ratio of 1 : 3. Forty-six candidemic cases and 150 matched controls were included in the study. C. tropicalis was the most prevalent species (22/46; 48%) followed by C. auris (8/46; 17%) and C. albicans (7/46; 15%). Candida species showed good sensitivity to echinocandins (97%) followed by amphotericin B (87%) and voriconazole (80%). In multivariate analysis, longer stay in ICU, presence of an indwelling device, use of immunosuppressive drugs and positive SARS-CoV-2 infection were associated with increased risk of candidemia. The constant evaluation of risk factors is required as prediction of risks associated with candidemia may help to guide targeted preventive measures with reduced morbidity and mortality.

Prevalence of fungal isolates in various respiratory samples at tertiary care hospital in Jaipur, Rajasthan

Prevalence of fungal isolates in various respiratory samples at tertiary care hospital in Jaipur, Rajasthan

Prevalence and Sensitivity Pattern of Methicillin Resistant Staphylococcus aureus in a Tertiary Care Hospital in Jaipur

Antimicrobial resistance (AMR) is a growing global health problem. Staphylococcus aureus is a commonest bacterium associated with community acquired and nosocomial infections. Methicillin resistant strains are increasingly being reported worldwide. In this study, we determined the prevalence and antimicrobial susceptibility pattern of Methicillin resistant Staphylococcus aureus (MRSA), isolated from various clinical specimens from a tertiary care hospital. The study comprised of 545 strains of Staphylococcus aureus isolated from various clinical specimens using standard microbiological procedures. From these isolates, methicillin resistant strains were screened, and their antimicrobial susceptibility pattern was detected according to CLSI 2020 guidelines. Out of 545 strains a total of 358 Strains were found to be methicillin resistant. In this study all MRSA strains were Vancomycin sensitive and majority of the MRSA strains were linezolid susceptible. However, Vancomycin intermediate and Linezolid resistant strains has been reported in some studies, but not found in our study.

Prevalence, epidemiology and clinical outcome of Candida auris infections: Experience from a tertiary care hospital in Jaipur.

Candida auris is identified as an emerging pathogen worldwide. It is multidrug resistant and causes invasive healthcare-associated infections. Our retrospective study was conducted to determine the prevalence and epidemiology of C. auris infections in a tertiary care hospital in Jaipur. 24 clinical C. auris strains were included, most being from urine. The majority patients needed intensive care and had at least one underlying co-morbid condition. A history of broad-spectrum antibiotic or antifungal usage was present in 85%. Fluconazole, voriconazole, amphotericin B and 5-fluorocytosine resistance was seen in 96, 42, 33 and 8% isolates respectively. No echinocandin resistance was noted.

Estimation of Demographic Parameters of COVID-19 Patients Admitted in a Tertiary Care Hospital, Jaipur

Background: COVID-19 is a pandemic disorder spreading rapidly worldwide. Most of the countries were affected by the COVID-19 during the year 2020. Demographic data are important to understand the impact of COVID-19 across the country and also provide information on an appropriate response, planning, and allocation of resources. This study aims to assess the demographic data of COVID-19 patients admitted and treated in a tertiary care hospital, Jaipur. Materials and Methods: This is a retrospective study conducted in a tertiary care hospital in Jaipur. A total of 1149 patients’ data like age, gender, area they belong to, duration of the treatment, etc., were collected from the medical records department (MRD) department between July 1, 2020 and September 30, 2020. The data were expressed as counts, number, and percentage (%). The data were analyzed using Excel software. Results: Out of 1149 patients, 70% were males and 30% were females, respectively, and mean ± SD (standard deviation) of age was 44.23 ± 3.57. Most of the cases were obtained from Jaipur 63%, Bikaner 5.4%, Ajmer 4.4%, Alwar 2.6%, Sawai Madhopur 2.6%, Dausa 2.3%, Nagaur 2.3%, Bharatpur 2.1%, and Karauli 1.7%, respectively, and remaining places reported

Prevalence of Bloodstream Infections and their Etiology in COVID-19 Patients Admitted in a Tertiary Care Hospital in Jaipur.

BackgroundWorld is in grip of coronavirus disease-2019 (COVID-19) pandemic right now. Majority of studies center around its epidemiological and clinical characteristics. Information regarding secondary bacterial infections is limited. This retrospective observational study was done to determine the prevalence and characteristics of bloodstream infections in COVID-19 patients admitted in a tertiary care center in Jaipur.Materials and methodsAll blood cultures received from COVID-19 positive patients admitted in designated COVID care ICUs and wards were included in the study. A predesigned pretested questionnaire was used to collect relevant data. Blood cultures were done using BD BACTEC™ FX40, and identification and antimicrobial susceptibility testing of isolates were done by VITEK® 2 COMPACT.ResultsOne thousand five hundred seventy-eight (1578) COVID-19 positive patients were admitted in center during 5-month study period from whom 158 blood cultures were received. Out of these, 15 (9.4%) were positive. Median age of patients with positive blood culture was 54 years and included 10 males and 5 females. Ten (67%) patients needed intensive care in ICU. Significant correlation of blood culture positivity was found with parameters like ICU admission, presence of an indwelling device, underlying comorbidity, raised biochemical markers, and adverse clinical outcome.ConclusionsIncidence of bloodstream infections is low for COVID-19 patients. Antibiotic prophylaxis needs to be used with caution, and prompt discontinuation should be done based on clinical judgment.How to cite this articleRajni E, Garg VK, Bacchani D, Sharma R, Vohra R, Mamoria V, et al. Prevalence of Bloodstream Infections and their Etiology in COVID-19 Patients Admitted in a Tertiary Care Hospital in Jaipur. Indian J Crit Care Med 2021;25(4):369–373.