Tertiary Care Hospital In Karnataka Research Articles

Comparative Study of Staphylococcus aureus Biofilm Formation among Clinical Isolates and Nasal Colonisers

Staphylococcus aureus (S. aureus) a noted versatile facultative commensal with pathogenic potential. This facultatively anaerobic cocci lives a commensal lifestyle in about a quarter of the world’s population awaiting a breach in the immune barrier to establish as a debilitating pathogen. This bacterium produces biofilms which acts as adhesive molecule enhancing the bacterial virulence and gives it an ability to withstand antibiotics, thereby causing tremendous burden on the healthcare community in terms of patient mortality and morbidity. This study assesses the biofilm producing ability among clinical isolates of staphylococci in comparison to colonizing staphylococci isolated from anterior nares of healthcare personnel. The present cross-sectional observational study was conducted in a tertiary care hospital in Mysore, India. In this study, 50 pathogenic isolates of S. aureus were assessed for phenotypic biofilm production. Additionally, 100 healthcare personnel were screened for nasal colonisation with S. aureus and the colonizing isolates were also screened for phenotypic biofilm formation. Phenotypic biofilm formation was evident among 22% of the pathogenic isolates. 23% of clinical S. aureus isolates demonstrated methicillin resistance (MRSA). There was no significant association of MRSA status with biofilm production (p > 0.05). Out of the 100 healthcare professionals screened for nasal carriage of S. aureus, 30% were colonized with S. aureus. Biofilm production among colonizing S. aureus isolates was found to be 26.6%. Methicillin resistance was a whopping 40% among the colonising strains. MRSA carriage was found to be highest among those healthcare personnel who had worked for an average of 20-30 years in the hospital environment. The Present study showed no significant association of biofilm production with the pathogenic potential of the S. aureus isolates (p > 0.05). Additionally, there was no significant association of methicillin resistance with the pathogenicity of the isolate. In conclusion, the interplay of virulence genes, biofilm forming ability, drug resistance of the isolate in coordination with the host immune status dictate the fate of the colonising as well as clinical isolates of S. aureus.

From dysbiosis to disease: Tracing gut microbiota's role in neonatal sepsis

IntroductionNeonatal sepsis remains a critical health issue, contributing significantly to morbidity and mortality among preterm infants. Dysbiosis, an imbalance in gut microbiota, is increasingly recognized as a key factor influencing the susceptibility to sepsis. This study aims to elucidate these associations by tracing gut microbiota development in preterm neonates. Methodology: A prospective cohort study was conducted at a tertiary care hospital in Karnataka, India, involving 182 preterm neonates (gestational age <37 weeks, birth weight <1500 g) from January 2021 to September 2023. Two cohorts were defined: Cohort 1 (Healthy neonates) and Cohort 2 (Neonates with sepsis). Stool samples were collected on day 4 and day 14 for microbiological analysis. Conventional culture techniques were used to identify bacterial isolates. ResultsThe study included 182 neonates, equally divided between two cohorts. On Day 4, Cohort 1 had 45 % E. coli and 44 % Klebsiella pneumoniae, which decreased to 40.7 % and 40.7 % by Day 14, respectively. Conversely, Bifidobacterium spp. increased from 30.8 % to 52.7 %. Cohort 2 exhibited higher persistence of pathogenic bacteria, with Klebsiella pneumoniae increasing from 70.3 % to 74.7 % and E. coli from 38.5 % to 51.6 %. Mode of delivery significantly influenced gut flora, with NVD linked to higher beneficial bacteria prevalence (Enterococcus faecalis and Bifidobacterium spp.). ConclusionThe study highlights significant differences in gut microbial patterns between healthy and sepsis neonates, emphasizing the role of initial gut colonization in neonatal health outcomes. Factors such as delivery mode and prenatal antibiotic exposure significantly impact gut microbiota composition, influencing infection susceptibility.

Gram-Negative Colonization and Bacterial Translocation Drive Neonatal Sepsis in the Indian Setting.

The gut microbiota, comprising billions of microorganisms, plays a pivotal role in health and disease. This study aims to investigate the effect of sepsis on gut microbiome of neonates admitted to the Neonatal Intensive Care Unit. A prospective cohort study was carried out in the NICU of tertiary care hospital in Karnataka, India, from January 2021 to September 2023. Preterm neonates with birth weight < 1500g and gestational age < 37 weeks were recruited, excluding those with congenital gastrointestinal anomalies, necrotizing enterocolitis, or blood culture-negative infections. The study population was divided into three groups: healthy neonates (Group A), neonates with drug-sensitive GNB sepsis (Group B), and neonates with pan drug-resistant GNB sepsis (Group C). Stool samples were collected aseptically, snapped in liquid nitrogen, and stored at -80⁰C for extraction of DNA and microbiome analysis. The gut microbiota of healthy neonates (Group A) was dominated by Proteobacteria (24.04%), Actinobacteria (27.13%), Firmicutes (12.74%), and Bacteroidetes (3%). Predominant genera included Bifidobacterium (55.17%), Enterobacter (12.55%), Enterococcus (50.69%), Streptococcus (7.92%), and Bacteroides (3.58%).Groups B and C, the microbiota exhibited higher Proteobacteria abundance (57.16% and 66.58%, respectively) and reduced diversity of beneficial bacteria. Notably, the presence of sepsis was associated with an increase in pathogenic bacteria and a decrease in beneficial commensal bacteria. Neonates with sepsis exhibited significant gut microbiome dysbiosis, characterized by increased Proteobacteria and reduced beneficial bacteria diversity. These findings highlight the potential of microbiome profiling as a diagnostic tool and underscore the importance of gut microbiota modulation in managing neonatal sepsis.

Knowledge and Practices of Airborne Infection Control at the Household Level among Pulmonary Tuberculosis Patients Attending a Tertiary Care Teaching Hospital in Central Karnataka, India

Abstract Background: Airborne transmission of tuberculosis (TB) is a major route of spread. Household contacts of TB patients are at high risk of infection. However, there is limited evidence on airborne infection control knowledge and practices among TB patients in India. This study was done to assess the knowledge and practices related to airborne infection control among pulmonary TB (PTB) patients at the household level and determine associated factors. Subjects and Methods: A cross-sectional study was conducted among 157 smear-positive PTB patients at a tertiary care hospital in Karnataka, India, using a pretested questionnaire. Knowledge and self-reported practices regarding airborne precautions were assessed. Bivariate analysis was done to determine associated factors. P &lt;0.005 was considered significant. Results: Major gaps were found in knowledge about ventilation (50.3%), avoiding visitors (39.5%), and sputum disposal (33.8%). Suboptimal practices were reported for using tissues (19%), handwashing (25%), ventilation (66%), sputum handling (54%), and waste disposal (30%). Good knowledge was associated with younger age, higher education, Hindu religion, family history of TB, intensive phase treatment, and presence of symptoms (P &lt; 0.05). Participants with good knowledge had significantly better preventive practices (P &lt; 0.00001). Conclusion: Tailored education on airborne precautions focusing on identified knowledge gaps and risky practices can help improve the adoption of infection control measures among TB patients at the household level. A multifaceted approach is required to translate improved awareness into optimal preventive behaviors.

Clinical and epidemiological profile of herpes zoster cases and its complications: A prospective study

Background: The varicella-zoster virus, which is known to lie dormant in the dorsal root ganglia after primary chickenpox infection or immunization, and in rare instances, intrauterine infection, is the source of the common viral infection known as herpes zoster (HZ). In healthy people, the illness usually goes away on its own, but in severely immunocompromised patients, it can cause persistent debilitation through multi-dermatomal, severe, vesiculo-pustular, nodular, crusted, and ecthymatous manifestations. Aims and Objectives: The aim of this study was to better understand the clinical profile and epidemiological patterns of HZ and various postherpetic complications. Materials and Methods: A prospective cross-sectional study was conducted at a tertiary care hospital in Karnataka for 24 months during August 2013–August 2015. Seventy-five patients with HZ and postherpetic complications attending the dermatology outpatient department were included in the study. Pre-existing comorbidities and patient details were recorded. The Hayes and Patterson Visual Analog Scale (VAS) was used to record the kind, duration, and intensity of the pain. Results: The current cross-sectional study was done in a tertiary care hospital, and a total of 75 patients were considered for the study. The youngest patient was a 12-year-old male and the eldest patient was a 90-year-old male. The average age of patients was 52.45 ± 12.5 years. Cutaneous examination showed erythema (84%) and vesicles (84%). The intensity of pain was classified based on the VAS. About 54.6% of patients had a moderate degree of pain. Conclusion: Acute vesicles with erythema and radicular pain with a unilateral dermatomal distribution are the most typical presentation of HZ infection, and they are most frequently seen in the thoracic area.

Clinical profile of herpes zoster in human immunodeficiency virus infected at a rural-based tertiary care center

Background: Due to the reactivation of the varicella-zoster virus, which had lainissed within sensory ganglions, herpes zoster (HZ) is typified by unilateral radicular pain and grouped vesicular eruption that is typically restricted to the dermatome innervated by a single spinal or cranial sensory ganglion. It is widely known that reactivation of varicella-zoster virus infection as HZ can cause morbidity in a human immunodeficiency virus (HIV)-positive host. Aims and Objectives: The aim of this study was to describe the clinical profile of HZ among HIV-positive patients in a rural tertiary care center. Materials and Methods: A prospective hospital-based study was conducted in a rural tertiary care hospital in Karnataka for duration of 24 months. All patients attending the outpatient department (OPD) of dermatology with clinical features of HZ and post-herpetic complications irrespective of their age and gender were included in the study. Data collection done in a semi-structured questionnaire on patient particulars as well as pre-existing co-morbidities was documented. Results: A cross-sectional study included 75 HZ patients attending OPD. Among the total 75 HZ patients, 11 were found to be seropositive for HIV infection. Seroprevalence among HZ was 14.6%. Among seropositive patients, the maximum belonged to the age group 41–60 years (63.3%). In the seropositive group, maximum cases (36.4%) occurred during summer while it was in the post monsoon season (39%) in the seronegative group. Conclusion: It is known that multidermatomal and severe pain is more commonly seen in HIV-infected patients than in the normal population. Many HIV-positive patients can present with a typical presentation of zoster as seen in our study.

Volumetric Analysis of Sphenoid Sinus in Patients with Symptomatic Nasal Septal Deviation: A Cross-sectional Study

Introduction: Nasal Septal Deviation (NSD) is known to influence the anatomy of the paraseptal structures, such as the lateral nasal wall and middle turbinate, thereby causing changes in ethmoid cell volume and maxillary sinus. However, there is not much literature on the influence of NSD on sphenoid sinus volume. Aim: To evaluate the effect of NSD on the volume of sphenoid sinus. Materials and Methods: A cross-sectional study was conducted over a period of one year at a tertiary care hospital in Karnataka, India on 45 patients with symptomatic NSD. Diagnostic Nasal Endoscopy (DNE) and Computed Tomography (CT) scans of the nose and Paranasal Sinuses (PNS) were performed on all patients. NSD was classified into three types based on the degree of septal deviation on CT scan. Sphenoid sinus volumes were measured, and the relationship between NSD and sphenoid sinus volume was analysed using OSIRIX software on the MAC system. Statistical analysis was done using the Wilcoxon signed-rank test and the Kruskal-Wallis test. Results: The mean age of the patients included in the study was 30.89±10.19 years. The male-to-female ratio was 2.75:1. The majority of the patients had NSD to the right (57%). NSD was found to be 1.3 times more frequent on the right-side compared to the left. The angle of NSD ranged between 2.10° and 18°. The majority of the patients were in group I (n=35), while group II and III had seven and three patients, respectively. The total ipsilateral volume was found to be 7.43±3.46 cm3 and the contralateral volume was 7.98±4.19 cm3 . There was no statistically significant difference between ipsilateral and contralateral sphenoid sinus volumes in the population (p-value=0.781). When each group was compared, no significant difference between the total sphenoid cell volumes on the ipsilateral (p-value=0.557) and contralateral (p-value=0.405) sides of the NSD was seen. Conclusion: NSD does not affect the volume of the sphenoid sinus, irrespective of the degree of septal deviation.

To assess the knowledge, attitude, and practice about prescribing fixed-dose combinations among medical doctors in a tertiary care hospital in Karnataka: A cross-sectional study

Background: Fixed-dose combinations (FDCs) constitute a substantial portion of prescribed medications worldwide and offer benefits such as enhanced efficacy, reduced pill burden, and improved patient compliance. However, their improper utilization can lead to inefficacies, increased costs, and adverse health outcomes. The assessment of clinicians’ understanding, attitudes, and practices regarding FDC prescription at a tertiary care teaching hospital in South India serves as a crucial step toward ensuring informed and rational medication practices. Aims and Objectives: The aim and objectives of the study are to evaluate the knowledge, attitude, and practice of prescribing FDCs among medical doctors. Materials and Methods: Following approval from the Ethics Committee at Mysore Medical College and Research Institute, as well as obtaining written informed consent from medical doctors working in the institute, a selfadministered, structured, and pre-tested questionnaire was utilized. This questionnaire had been adapted from prior studies with similarities and was adjusted to align with the specific context of the present study. Results: The study of 72 doctors highlighted high FDC awareness (91.7%). The generic name of FDC was employed by 69.4% of the participants in the study. Most advocated proper prescriptions (84.8%). 57% of them identified FDC rationality. 22.2% relied on drug indexes, among other varied sources, for FDC information. Conclusion: It is essential to emphasize gaps in knowledge, attitude, and practice as it increases the risk of irrational prescriptions. Measures aiming to educate and rectify this issue, particularly in a tertiary hospital setting, help in mitigating the irrational use of drugs and optimizing patient care.

Study of Phospholipase A2 Levels and Its Comparison With Procalcitonin Levels in Patients With Sepsis Admitted in a Tertiary Care Hospital, Karnataka, India.

Sepsis is a complicated host response to infection involving organ failure which ultimately causes death of the host. Procalcitonin (PCT) is an effective marker used to diagnose sepsis but until now, there has been no ideal marker for sepsis. Phospholipase A2 (PLA2) also increases infections; however, only a few studies have assessed its capacity as a biomarker to diagnose sepsis. Thus, we aimed to examine PLA2 and compare its diagnostic capacity and accuracy with PCT as a biomarker of sepsis. Our study was a hospital-oriented cross-sectional study. Our study group included 80 patients of both sexes older than 18 years, meeting the quick sequential organ failure assessment (qSOFA) or systemic inflammatory response syndrome (SIRS) criteria of ≥2, hospitalized in a tertiary care hospital in Karnataka, India from January 2021 to December 2021. Out of them, 59 were found to have sepsis. Samples of all the patients were evaluated for relevant parameters, and data were statistically analyzed using SPSS v21 running on Windows 10. The statistical significance was set at p-value <0.05. The mean PCT and PLA2 were significantly raised in sepsis patients compared to non-sepsis patients. Out of 59 septic patients, 45.76% had positive blood cultures, and 16.95% had positive urine culture reports. In blood cultures, the most common Gram-positive organism found was Staphylococcus, and the most common Gram-negative organism was Enterobacter. In urine cultures, Escherichia coli was the most common species. PLA2 was significantly higher in patients with bacterial etiology and Gram-positive cultures. The diagnostic capability, sensitivity, specificity, and accuracy of PLA2 were demonstrably higher than those of PCT. Our study proves that PLA2 is a much better and more efficient biomarker in sepsis than PCT. The diagnostic capacity and accuracy of PLA2 clearly surpass PCT, so using PLA2 in sepsis as a biomarker can help clinicians in deciding on timely and appropriate management to speed the recovery of patients.

A retrospective exploratory analysis on surgical site infections in a tertiary care hospital in Karnataka

Background: Surgical site infections (SSIs) are the highest reported complications of surgery and serious postoperative nosocomial infections associated with patient morbidity, prolonged hospitalization, and economic burden. This study was conducted to estimate the prevalence of SSIs, bacterial profile, and their antimicrobial susceptibility among patients who underwent surgery and subsequent SSIs at a tertiary care hospital in a coastal district of Karnataka, India. Methods: A retrospective study was conducted by collecting the data of patients diagnosed with SSIs at tertiary care hospital during the period of four years from 2018 January to 2021 December. Data analysis was performed to estimate the prevalence of SSI, determine the bacterial profile and their antibiotic susceptibility using Jamovi software. Results: Among 95611 patients who underwent surgery, a total of 443 (0.46%) patients were clinically diagnosed with SSI. Maximum SSI cases were obtained from the Department of Orthopaedics (42.2%), followed by General Surgery (22.3%) and Neurosurgery (6.5%). Staphylococcus aureus (39.0%) was the most predominant bacteria among the isolates, followed by Escherichia coli (19.04%) and Klebsiella pneumoniae (10%). A total of 55.6% of Staphylococcus aureus exhibited methicillin resistance. Most of the bacterial isolates were susceptible to Trimethoprim sulphamethazole, Gentamycin and Amikacin. Conclusions: Though the prevalence of SSI is less it requires due attention to prevent the SSIs in the hospitals. Identification of risk factors help in planning the preventive strategies. Consistent Infection control practices are implemented in hospital for preventing the transmission of diseases, strengthening the antimicrobial stewardship program and regular antimicrobial surveillance.

Association of ABO blood groups with the severity of coronary artery disease in southern India population: A prospective cross-sectional study

This study aimed to find an association between ABO blood groups with presence and severity of Coronary artery disease (CAD) among Indian population. 1500 patients undergoing elective coronary angiogram (CAG) at a tertiary care hospital in Karnataka were enrolled in the study. Baseline demographic data and the presence of cardiac comorbidities were documented. Data from baseline echocardiography and angiographic studies were compiled. The incidence of CAD was higher among patients with blood group A. Blood group A also showed a higher incidence of acute coronary syndrome (ACS), left ventricular dysfunction, triple vessel disease, and severe CAD among the patients who underwent CAG.

ERRORS IN USING INHALER DEVICES AMONG COPD PATIENTS: A PROSPECTIVE COHORT STUDY

Background: Pharmacological treatment of chronic obstructive pulmonary disease (COPD) is mainly based on inhaled medications. Inappropriate use of inhalers due to the unrecovered peak inhalation ow rate (PIFR) results in an increased risk of early treatment failure. Therefore, this study was carried out to address the error patterns in using dry powder inhalers (DPI) versus pressurized metered-dose inhalers (MDI) inhaler devices among COPD patients with acute exacerbation. For this Methods: prospective cohort study, a cohort of 138 COPD patients with acute exacerbation were included from a tertiary care hospital in Karnataka. The inhalation technique and PIFR were evaluated at discharge and twice in follow-up at 15-day and 90 days intervals based on a list of the most common errors in the inhalation techniques. About 63% Results: of patients had comorbidities. The average length of hospital stay was 7.8 days and the mean PIFR value at discharge was 58.9L/min. About 51.4% of the COPD patients were MDI users and 48.6% were DPI users. The most frequent errors were inappropriate inhaling and short breath holding time for DPI (89.6% and 88.1%) and MDI (84.5% and 94.3%) device users, respectively. At follow-ups, these errors- inhaling deeply and shortbreath holding time continued to occur signicantly during 90-day follow-ups for DPI (79.1% and 82.1%) and MDI (79.2% and 90.1%) device users, respectively. However, the breath-out and mouthpiece placing errors were reduced signicantly at 90 days of follow-up among the DPI (50.7% and 40.3%, respectively) and MDI users (47.9% and 19.8%, respectively). Inappropriate inhali Conclusions: ng and short breath holding time were the most frequent and major errors made by inhaler device users. This emphasizes the training in proper inhalation techniques for COPD patients treated with inhalers

Leprosy in the 21st Century - An Evaluation of Clinical Spectrum and Histopathological Correlation of Leprosy in Tertiary Care Hospital in Karnataka

Leprosy in the 21st Century - An Evaluation of Clinical Spectrum and Histopathological Correlation of Leprosy in Tertiary Care Hospital in Karnataka

Thyroid Dysfunction and its Correlation with Section Metabolic Syndrome among Perimenopausal and Postmenopausal Women Attending a Tertiary Care Hospital in Karnataka: A Cross-sectional Study

Introduction: Thyroid dysfunctions are more common among women than men and increase near menopause. These are also associated with metabolic syndrome, increasing cardiovascular risk. These cardiovascular events and cerebrovascular events increase women’s morbidity and mortality, especially after menopause. Though many researchers in the past few decades have tried to highlight this problem, majority of them have focused on the elderly population. Studies on women of the perimenopausal age group are still not frequently found. Aim: To assess the correlation between thyroid dysfunction and metaoblic syndrome among perimenopausal and postmenopausal women. Materials and Methods: A cross-sectional study was conducted among women attending the Medicine Outpatient Department (OPD) of Adichunchanagiri Institute of Medical Sciences, Nagara BG, Karnataka, India, from December 2017 to May 2019. Total 100 participants were included in the study, of which 50 were perimenopausal and 50 were postmenopausal women. Clinical history, examination and relevant investigations {Free T3 or Total T3, Free T4 or Total T4, Thyroid Stimulating Hormone (TSH)} were recorded. Association was studied using Chi-square test, groups were compared using Analysis of Variance (ANOVA) test, and correlation was estimated using Pearson’s correlation test. Results: Mean age of the study participants was 55.14±8.05 years. Thyroid dysfunction was observed in 17% of the participants, of whom 14% had subclinical hypothyroidism, 2% had overt hypothyroidism and 1% had hyperthyroidism. Prevalence of metabolic syndrome was 45%. There was a significant association of hypothyroidism with Fasting Blood Sugar (FBS) (p-value=0.005) and a positive correlation between FBS and TSH level and High Density Lipoprotein (HDL) with T3 and T4 levels. Conclusion: Prevalence of hypothyroidism and metabolic syndrome were high among perimenopausal women and as FBS increases or HDL decreases, the chances of hypothyroid increases. Therefore, early identification and reduction of these components of metabolic syndrome decreases hypothyroidism and cardiovascular events.

Understanding the economic burden of cancer care and the utility of health insurance: An exploratory cross-sectional study in a tertiary care hospital in Karnataka, India.

Families and caregivers of cancer patients experience significant financial challenges associated with out-of-pocket (OOP) expenditures. This study aims to assess the OOP expenditure and its impact on the livelihood of patients and families, associated with receiving cancer care from a teaching hospital in Karnataka. It focuses on understanding health insurance use and its effects on OOP expenses for cancer care based on data obtained from 271 patients receiving treatment for more than 6 months. A structured questionnaire was developed and used for data collection and focused on obtaining direct costs such as consultation fees, surgery costs, and radiotherapy costs and indirect costs such as travel expenses, food costs, and patient income loss, as well as questions that measure the impact of the financial burden on patients and their associated livelihood. In the present study, the median cost of OOP expense incurred for cancer treatment is estimated to be 3.10 lakh Indian rupees. It was also found that patients enrolled in public health insurance schemes, especially Ayushman Bharath-Arogya Karnataka have lesser OOP expenditure than those with either private health insurance or no health insurance. This indicates the need for effective implementation of various public health insurance schemes and their ability to protect patients from huge OOP expenses and related financial risks.

A Report on Cases with Communication Disorders at a Tertiary care Hospital in Mysore District of Karnataka, India: A Retrospective Study Across Five Years.

Communication disorders affect an individual's social, emotional and behavioural well-being. Estimating the number of clients with various causes of communication disorders can assist in the prevention, early identification, intervention, rehabilitation and counsellingprocess. India is the second-largest populated country with diversity in terms of culture and geography. Therefore, estimating the data on number of clients presenting with communication disorders is warranted across different parts of the country. In a retrospective study, the clinical records of cases reporting to the JSS Institute of Speech and Hearing, Mysore, for the last five years were reviewed. A total of 9511 cases diagnosed with communication disorders were includedin the study. The percentage of male cases was higher than the females amongst all the types of communication disorders. The percentage of paediatric cases with speech and language disorders was the highest, followed by adult cases. Across the hearing disorders, the highest number of cases were from the adult age group, and the lowest number of hearing-disordered cases were noted in the paediatric age group throughout all five years. Among all the risk factors, perinatal history was the highest seen risk factor, and consanguinity was the lowest seen risk factor associated with communication disorders. Theresults of the present study revealed that among cases with communication disorders at the tertiary care hospital in Mysore, hearing impairment was one of the most commonly seen conditions, followed by child language disorders. The history of perinatal factors as a risk for communication disorders was noted in a maximum number of cases.

Prevalence and Age of Hypertension in Patients with Overt Primary Hypothyroidism in a Tertiary Care Centre in India

Introduction: Hypertension and hypothyroidism are common problems in the community. Although the hypothyroidism prevalence in people with hypertension has been reported, there are limited studies about hypertension prevalence in hypothyroid patients. This study aimed to analyze the prevalence and age of hypertension among patients with overt primary hypothyroidism in a tertiary care center in India.&#x0D; Methods: A descriptive cross-sectional study was conducted among hypothyroid patients who consecutively attended a tertiary care hospital in Karnataka, India from 1 November 2020 to 30 September 2021. Purposive sampling method was used. Data was tabulated in MS Excel version 16 and analyzed via Statistical Package for Social Sciences (SPSS) Version 20.0.&#x0D; Results: A total of 520 overt primary hypothyroid patients with 141 (27.1%) men and 379 (72.9%) women were included in the study. The mean age of the hypothyroid patients was 52.20 ± 16.414 years, with 58.27 ± 17.339 years of male and 49.95 ± 15.483 years of female (p &lt; 0.05). The prevalence of hypertension among total hypothyroid patients was 225 (43.3%) (39-47.54, 95% CI) with 77 (54.61%) (46.29-62.93, 95% CI) in men and 148 (39.1%) (34.12-43.98, 95% CI) in women (p &lt; 0.05). The mean age of patients with hypertension was 59.97 ± 13.218 years, with 65.39 ± 11.642 years of male and 57.15 ± 13.144 years of female (p &lt; 0.05). 2&#x0D; Conclusions: The prevalence of hypertension in hypothyroid patients was similar to prevalence in the general population and was higher in males than in females. The gender-wise distribution of patients with hypertension among hypothyroidism was more in females due to the high proportions of female in patients with hypothyroidism.

CHEST RADIOGRAPHIC FINDINGS IN RT-PCR POSITIVE COVID-19 PATIENTS

Aims and objectives : To describe the chest radiographic ndings in RT-PCR positive COVID 19 patients and to evaluate the effectiveness of chest radiographs in detecting pulmonary alterations in RT-PCR positive COVID-19 patients. Materials and methods: A retrospective cross-sectional study was carried out from May 2021 to June 2021 in a tertiary care hospital in Karnataka, India. A total of 100 covid positive patients who underwent chest X-ray were included in the study. The chest X-rays were evaluated for presence or absence and the type of pulmonary alterations, and their distribution. Chi-square test was used to compare percentages and p- value of less than 0.05 was considered statistically signicant. Results: In total, 100 patients consisting of 70 males and 30 females with positive RT-PCR results for COVID-19 pneumonia were included in this study, their mean age being 51.6 years. The presence of at least one chest alteration was found in 90 patients. The presence of ground-glass opacities (51%) and consolidation (41%) was the most common ndings. Reticular opacities were found in 6% of the cases. Seventy percent of the radiographic ndings were bilateral and involvement of both peripheral and central zones was signicantly frequent. Conclusion: Frequent ndings at chest radiography in patients with COVID-19 included bilateral lower zone ground glass opacity and consolidation.

Utility of Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as A Predictor of Mortality in COVİD-19

Coronavirus-19 pandemic has stricken our world since December 2019; the disease, first reported in China, is now a pandemic. More than 400 million people have been affected, and 5 million people have succumbed to the disease. Hence, it is the need of the era to find readily available laboratory parameters to assess the mortality chances in these patients. Our study aims to determine the utility of NLR and PLR ratios as a predictor of severity and clinical outcome of COVID-19 patients.100 patients admitted to a tertiary care hospital in Karnataka, India, during the months April to July 2020 were studied. Only patients with a positive RT-PCR (Reverse Transcriptase Polymerase Chain Reaction) report for COVID-19 were included. Demographic data, comorbidities, and mortality status were collected from electronic hospital records. Lab parameters including- Total Count (TC), Absolute count of neutrophils and lymphocytes, platelet count were taken. NLR and PLR were derived from available lab parameters. Patients were categorized into varying severity depending on their SpO2 levels at admission. Neutrophil count (P=0.001) and NLR (P=0.002) were associated with an increased risk of mortality and disease severity. An increase in PLR ratio (P=0.05) shows a mild association with mortality but not with disease severity (P=0.096). In contrast, comorbidities, increasing age, and gender did not show any statistical significance for mortality. The presence of statistical significance concerning NLR and PLR should be utilized as an aid by clinicians to assess disease severity and chances of mortality. As new variants of the disease are uprising and a single therapeutic measure is not available currently for the treatment of COVID-19, clinicians should be well informed about how to monitor the disease in a cost-effective and easily accessible way to reduce the disease mortality and morbidity.

Clinical and laboratory profile of children with COVID-19 admitted at a tertiary care hospital in Karnataka, Southern India

The Journal is the primary organ of Continuing Paediatric Medical Education in Sri Lanka. The journal also has a website. Free full text access is available for all readers.The Sri Lanka Journal of Child Health is now indexed in SciVerse Scopus (Source Record ID 19900193609), Index Medicus for South-East Asia Region (IMSEAR), CABI (Centre for Agriculture and Bioscience International Global Health Database), DOAJ and is available in Google, as well as Google Scholar.The policies of the journal are modelled on the Committee on Publication Ethics (COPE) Guidelines on Principles of Transparency and Best Practice in Scholarly Publishing. Sri Lanka Journal of Child Health is recognised by the International Committee of Medical Journal Editors (ICMJE) as a publication following the ICMJE Recommendations.