Journal of Evidence Based Medicine and Healthcare最新文献

{"title":"Significance of Serum Potassium Level at Admission in Organophosphorus Poisoning and Impact on Outcome - A Hospital Based Study from North East India","authors":"Bijush Difoesa, D. Sharma, S. Hari, D. Deb","doi":"10.18410/jebmh/2021/596","DOIUrl":"https://doi.org/10.18410/jebmh/2021/596","url":null,"abstract":"BACKGROUND Organophosphorus (OP) pesticides are one of the most common cause of morbidity and mortality due to poisoning worldwide especially in agrarian countries like India. Hence it is prudent to undertake a detailed study of clinico-pathological evaluation of OP poisoning and assess the role of serum potassium as an alternative, easy and convenient prognostic indicator in estimating the severity of OP poisoning. This study was undertaken to assess serum potassium levels in patients of acute organophosphorus poisoning and determine association between serum potassium level and outcome in cases of acute organophosphorus poisoning. METHODS This was a prospective observational study conducted in Department of General Medicine, Silchar Medical College & Hospital for one year from 1st June 2019 to 31st May 2020 with a sample size of 100 after satisfying the inclusion and exclusion criteria. Peradeniya organophosphorus poisoning (POP) scale was used for categorizing study population according to severity. RESULTS Among patients who were admitted with organophosphorus poisoning, 72 % of the patients discharged were having normal serum potassium levels on admission, whereas 22 % (n = 22) patients who died had hypokalaemia at the time of admission. The chi-square value for the association between serum potassium and outcome is statistically significant [P value is 0.001 (P < 0.05)]. CONCLUSIONS The serum potassium level on the day of admission was significantly correlated with the severity of the acute organophosphate poisoning as determined by Peradeniya OP poisoning scale. The cases that had lower serum potassium levels on admission had poor outcome. Reduced serum potassium levels also had significant association with the need for ventilator support. Therefore, serum potassium can be used as a predictive marker of severity in organophosphorus poisoning. This can help in early triage of patients and will be helpful in reducing mortality and morbidity. KEYWORDS Organophosphorus Compound Poisoning, Serum Potassium, POP Scale","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86930419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admissions for Stroke and Strategies to Optimize Healthcare Delivery During the COVID-19 Pandemic - Experience from a Tertiary Care Hospital in South India","authors":"K. John, R. Roy, Bincy Baby, Deep P. Pillai, Anilkumar Sivan, Joban John, S. Koshy, J. K. John","doi":"10.18410/jebmh/2021/599","DOIUrl":"https://doi.org/10.18410/jebmh/2021/599","url":null,"abstract":"BACKGROUND COVID-19 is associated with a hypercoagulable state and stroke is one of its most common neurological complications. The current study is aimed at investigating the effect of the COVID-19 pandemic on hospital admissions for stroke. METHODS We conducted a retrospective observational study to determine if there was a significant difference in the number of hospital admissions for stroke during the 2 months of lockdown and the two preceding months, (starting on 24 March 2020). The numbers were also compared with the figures during the same months in the previous year. The numbers were also compared to the same months one year prior. The secondary objectives were to compare the time between the onset of stroke and presentation to the hospital, type of strokes that presented to the hospital, severity of stroke, number of code activations, number of thrombolysis conducted, and in-hospital mortality between the same time periods. RESULTS The total number of patients admitted for stroke during the time periods from 25th March 2019 to 24th May 2019, 25th January 2020 to 24th March 2020 and 25th March 2020 to 24th May 2020 were 82, 72 and 75 respectively, and there was no statistically significant difference between these numbers. However, there was a significant increase in the proportion of stroke cases when compared to total hospital admissions. This suggests that an increase in stroke incidence may have been masked by a reduction in the total number of patients presenting to the hospital. The National Institutes of Health Stroke Scale (NIHSS) score of the patients who presented during the lockdown were higher. There were no significant differences in the time between the onset of stroke and presentation to the hospital, type of strokes that presented to the hospital, severity of stroke, number of code activations, number of thrombolysis conducted, and in-hospital mortality between the periods under study. CONCLUSIONS The present study suggests that there may be a relative increase in the incidence of stroke in the community, as a result of the COVID-19 pandemic. The patients who presented with stroke during the lockdown period had a higher NIHSS score. KEYWORDS COVID-19, Stroke, Lockdown","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"85 11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83227694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study between Bedside Index for Severity in Acute Pancreatitis (BISAP) and Acute Physiology and Chronic Health Evaluation (APACHE-II) Scoring System in Assessing the Severity of Acute Pancreatitis at Bangalore Medical College and Research Institute, Bangalore, India","authors":"Akhila Nallur Theerthegowda, P. Umashankar, Nagashri Suresh Iyer","doi":"10.18410/jebmh/2021/594","DOIUrl":"https://doi.org/10.18410/jebmh/2021/594","url":null,"abstract":"BACKGROUND Acute pancreatitis (AP) is an inflammatory disease of the pancreas, that results from intrapancreatic activation, release, and digestion of the organ by its own enzymes. The diagnosis of acute pancreatitis can be made when a patient presents with threefold elevated serum levels of amylase or lipase, abdominal pain and vomiting. In this study, we wanted to assess the severity of acute pancreatitis by using BISAP (Bedside index for severity in acute pancreatitis) and APACHE-II (Acute physiology and chronic health evaluation) scoring systems and compare the accuracy of BISAP scores with APACHE-II scores. METHODS A prospective study including 201 patients was conducted from April 2018 to March 2020 in Victoria Hospital, affiliated to BMCRI. RESULTS Among 201 AP patients, 129 were found to have mild acute pancreatitis (MAP), 72 were of severe acute pancreatitis (SAP), 192 survival cases, and 9 death cases. The larger the rating score, the higher the proportion of severe pancreatitis and mortality risk. Two kinds of scoring criteria; BISAP score points and Apache II score points compared in patients with MAP and SAP, In Apache II score to predict severity of organ failure, the sensitivity, specificity, positive predictive value, negative predictive value was 84.72 %, 93.02 %, 87.14 %, 91.60 % and area under the curve was 0.958 (P < 0.0001). In BISAP, the sensitivity, specificity, positive predictive value, negative predictive value was 90.28 %, 80.62 %, 72.22 %, 93.69 % and area under the curve was 0.917 (P < 0.0001). CONCLUSIONS Ability of APACHE II score prediction of AP in severity of organ failure and mortality are stronger than BISAP score, But APACHE II scoring system indicators were cumbersome, complicated assessment. BISAP scoring system is simple, economical, rapid and reliable, and it can effectively predict the severity and mortality of acute pancreatitis, and can be used as a preliminary screening method in accurate risk stratification and initiation of management accordingly at community health care, secondary health care and tertiary health care Hospitals. KEYWORDS Pancreatitis, Severity, Prediction, APACHE II and BISAP","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75390249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Students Perception of Educational Environment During Paraclinical Training in a Government Medical College in North-East India - A Cross-Sectional Study","authors":"Abhijit Datta, Sayantika Ghosh, R. Das","doi":"10.18410/jebmh/2021/598","DOIUrl":"https://doi.org/10.18410/jebmh/2021/598","url":null,"abstract":"BACKGROUND A warm, optimally supportive, challenging, and competitive environment is widely regarded as an essential pre-requisite for best possible learning. Students’ satisfaction on educational environment influences their learning approach and outcome. The Dundee ready educational environment measure (DREEM) is a globally accepted valid tool to assess educational environment during undergraduate medical education, in which students are scored for 50 items with a total global score of 200. This study was undertaken, as there had been paucity of relevant data from north-east India, with the aim of assessing students’ perception of their educational environment in paraclinical training during second professional MBBS course. METHODS This was a cross-sectional survey-based study conducted during the months of September and October, 2017 involving 168 second professional MBBS-students of third and fifth semesters of Government Medical College of north-east India. DREEM questionnaire was used to assess the educational environment, as perceived by the students, during paraclinical training. RESULTS This study showed that the mean global score involving all the domains was 119.58 ± 46.95, suggesting a ‘more positive than negative’ educational environment prevailing in the institute during paraclinical training. The individual domain scores for their - perception of learning was 29.90 ± 5.32, perception of teachers was 27.68 ± 4.13, academic self-perception was 18.96 ± 3.78, perception of atmosphere was 26.93 ± 6.40 and social self-perception was 16.11 ± 3.34, suggesting that the training was moving in right direction across all the domains of educational environment, though was not optimally perfect. CONCLUSIONS The present study revealed a suboptimal perception of undergraduate medical students in all the domains of educational environment in paraclinical phase. The overall educational environment during paraclinical teaching moving in a satisfactory direction though was not excellent. Social perspectives of the educational environment need to be further improved. KEYWORDS Educational Environment, DREEM Inventory, Paraclinical Training, Students’ Perception, Global Score","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78013750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Study and Compare the Effect of Pre-Operative Skin Preparation with Aqueous Povidone Iodine Only and in Combination with Alcoholic Chlorhexidine on Surgical Site Infection in Tertiary Care Hospital SVRRGGH, Tirupati","authors":"P. Adeppa, G. Prakash, G. Purushotham, Sumesh Raja Shanmugapandi","doi":"10.18410/jebmh/2021/591","DOIUrl":"https://doi.org/10.18410/jebmh/2021/591","url":null,"abstract":"BACKGROUND Even the normal skin of healthy humans usually harbours a rich bacterial flora, which are usually non-pathogenic. But these organisms always have a potential to cause infection of the surgical site. The aim of surgical site preparation with antiseptics is to remove microorganisms harbouring the skin surface to a lower level. Povidine iodine (iodophors) and chlorhexidine are the agents most often used for pre-operative surgical site antisepsis. In this study, we wanted to determine the efficacy of pre-operative skin preparation with aqueous povidone iodine alone and when used in combination with alcoholic chlorhexidine for surgical site asepsis. METHODS This is a cross-sectional study. 200 patients (100 in each group) were considered for the study who were undergoing clean elective surgery. Pre-operative preparation of skin in the surgical area was done by the respective antiseptic which was planned accordingly, after such application, sterile saline swab culture was taken immediately from the site of incision during surgery. In the cases which showed growth of organisms, they were isolated from colonies and subjected to gram staining, coagulase test and antibiotic sensitivity test. The organisms thus isolated were identified by their morphological and cultural characteristics and difference in colonization rates were considered as a measure of antiseptic regimen efficacy. RESULTS The results showed that, usage of povidine iodine along with alcoholic chlorhexidine is more efficacious and showed significant reduction of colonization rates at the site of incision, in comparison to using povidone iodine alone. Postoperative wound infections were lower, when povidine iodine is used in combination with chlorhexidine is used for pre-operative surgical site preparation. CONCLUSIONS Pre-operative skin preparation with the chlorhexidine gluconate 2.5 % v/v in 70 % propanol followed by aqueous povidone-iodine solution is an ideal for broad spectrum asepsis and the post-operative wound infection rate is much lower as compared to povidone iodine alone. KEYWORDS Skin Disinfection; Chlorhexidine; Propanol; Povidone-iodine; Bacterial Colonization","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87777595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of Multi-Organ System Involvement in Perinatal Asphyxia at a Tertiary Care Hospital in Southern India - A Descriptive Study","authors":"Soumya Satna, Ramadevi Devagudi, Ramu Pedada, Narayana Lunavath","doi":"10.18410/jebmh/2021/587","DOIUrl":"https://doi.org/10.18410/jebmh/2021/587","url":null,"abstract":"BACKGROUND Perinatal asphyxia (PA) is an important cause of neonatal morbidity, mortality, and neurologic handicap in children. Dysfunction of organs other than central nervous system is often recognised after perinatal asphyxia and manifests as hypoxic ischaemic insults to heart, lungs, kidneys and bowel. The purpose of this study was to assess the spectrum of multi-organ system involvement in perinatal asphyxia. METHODS This observational, descriptive study was conducted at SVRRGGH (Sri Venkateswara Ramnarayan Ruia Government General Hospital) - Tirupati from October 2010 to September 2011 and has Institutional Ethics Committee approval (Regd. No: 58647, Dt: 20 / 11 / 2010). After considering the inclusion and exclusion criteria, 204 neonates diagnosed with perinatal asphyxia who got admitted in our newborn intensive care unit (NICU) were included in this study. RESULTS In the present study, we had 118 (57.89 %) male babies and 86 (42.11 %) female babies. The mean birth weight was 2640 +/- 460 grams. Infants of birth weight 2500 - 4000 grams (appropriate for gestational age - AGA) accounted for 202 (98.96 %). Major maternal risk factors in this study were MSAF (meconium-stained amniotic fluid (66/204, 32.4 %), PIH (pregnancy induced hypertension) and Eclampsia (26/204, 12.7 %) and PROM (premature rupture of membranes) (26/204, 12.7 %). In the present study, we found higher mortality (19/117, 16.2 %) in babies born to multiparous mothers. Respiratory system involvement was seen in 80 (39.2 %) infants. Renal involvement was observed in 58 (27.5 %) infants. Acute renal failure was diagnosed in 22 (10.8 %) cases. CVS (cardiovascular system) involvement was seen in 56 (27.5 %) cases where as GIT (gastrointestinal tract) involvement was found in 32 (15.68 %) cases. CONCLUSIONS Epidemiological research is needed to accurately estimate the contribution of birth asphyxia to perinatal morbidity and mortality, especially in community settings where the burden of disease, due to high proportion of unattended deliveries, is likely to be larger than the hospital setting. KEYWORDS Perinatal Asphyxia, Neonatal Intensive Care Unit, Hypoxic Ischaemic Encephalopathy, Multi Organ Dysfunction, Cardiovascular System","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87575212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Study of Clinical Profile in Febrile Illness with Thrombocytopenia in Children Aged 1 to 12 Years Admitted in a Tertiary Care Centre in Telangana","authors":"S. Martha, Goutham Deeti, Chaitanya Jyothi Ravula, N. Cherukuri, Srinivasa Suresh Nadavapalli","doi":"10.18410/jebmh/2021/590","DOIUrl":"https://doi.org/10.18410/jebmh/2021/590","url":null,"abstract":"BACKGROUND Fever with thrombocytopenia is a common clinical problem in paediatric wards. Significant number of acute febrile illnesses have an infectious aetiology and are often associated with thrombocytopenia. The objective of the study was to determine the clinico-etiological profile and outcome of children admitted with febrile thrombocytopenia, especially in those with infective aetiology. METHODS The study design is a prospective observational study. It was conducted from September 2017 to August 2019 in the Department of Paediatrics, Niloufer Institute of Women and Child Health, Hyderabad. A total of hundred (100) children in the age group of 1 year to 12 years presented with fever, and thrombocytopenia were included in the study. Newborns, infants, children with febrile thrombocytopenia, known ITP (idiopathic thrombocytopenic purpura), already diagnosed haematological malignancy and children on antiplatelet drugs like aspirin were excluded from the study. After informed written consent, detailed history was elicited, clinical examination and necessary laboratory investigations were carried out, and the data was captured in a pre-structured proforma. Study parameters were analysed using Statistical Package for Social Sciences (SPSS) version 16 software. RESULTS The study included 100 children. A ratio of 1.4 : 1 was observed in male to female ratio. As of the clinical features, gastrointestinal (GI) symptoms such as nausea, vomiting and pain abdomen were more common, followed by headache and myalgia. On examination, two-thirds of the children had hepatomegaly, and onethird had splenomegaly. Among 100 children with febrile thrombocytopenia, 38 children had bleeding manifestations (cutaneous bleeds > GI bleeds > other bleeds) in those with moderate to severe thrombocytopenia. In the etiological profile, dengue fever was more common, followed by undiagnosed fever, enteric fever, ALL (acute lymphoblastic leukemia), scrub typhus, malaria and leptospira, respectively. Out of 100 children, 94 were discharged, and 6 children with ALL were referred to the haemato-oncology center for further management. CONCLUSIONS Clinical presentation of cases with febrile thrombocytopenia is varied. Common causes of febrile thrombocytopenia observed in this study were dengue fever followed by un diagnosed fever and enteric fever. KEYWORDS Fever, Thrombocytopenia, Platelet count, Bleeding","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85441353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of Vitamin D Levels in Acute Ischaemic Stroke - A Study from Amritsar, Punjab","authors":"Pooja Parteek, Manish Chandey, S. B. Nayyar, P. Verma, Raminderjit Singh","doi":"10.18410/jebmh/2021/593","DOIUrl":"https://doi.org/10.18410/jebmh/2021/593","url":null,"abstract":"BACKGROUND World Health Organization (WHO) defines stroke as “rapidly developing clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin.” Low serum 25 hydroxy vitamin D is associated with large infarct volume, which worsens the outcome in ischemic stroke patients. In this study, we wanted to evaluate serum vitamin D levels in acute ischaemic stroke (AIS) patients and correlate the severity of stroke with lipid profile & central nervous system (CNS). METHODS It was a cross sectional comparative study, conducted in Department of Medicine in SGRDIMSR, Sri Amritsar from December 2018 to June 2020. A total of 100 subjects, 50 cases of AIS, diagnosed by history, clinical examination and supported by magnetic resonance imaging (MRI) of brain and 50 age and sex matched healthy controls were enrolled for the present study to estimate serum vitamin D level in AIS. Detailed clinical history and clinical examination were done on all participating subjects and relevant investigations were done. Diagnosis was confirmed by MRI brain in acute ischemic stroke cases. The severity of neurological impairment was evaluated as per Canadian neurological stroke scale within 24 hours of admission of the cases. RESULTS Mean age of cases was 62.06 ± 10.52 years and mean age of control was 59.14 ± 11.36 with maximum number of subjects were in age group of 61 - 70 years. The mean value of vitamin D in study group was 19.31 ± 9.24 while in control group, mean value was 36.42 ± 8.33, showing more serum vitamin D deficiency in cases having AIS than controls. (P value 0.021). CONCLUSIONS The present study suggests that the low serum vitamin D levels in the body is associated with more severe neurological deficit. KEYWORDS Stroke, Serum Vitamin D, Acute Ischemic Stroke, Canadian Neurological Scale","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73815082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Profile of Cardiac Manifestations of Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital in Guwahati, Assam","authors":"P. Roy, A. L. Khawbung, Ubedul Islam, S. Baruah","doi":"10.18410/jebmh/2021/592","DOIUrl":"https://doi.org/10.18410/jebmh/2021/592","url":null,"abstract":"BACKGROUND Chronic obstructive pulmonary disease (COPD) is a global issue with smoking being the most important risk factor. Co-existence of both COPD and cardiovascular diseases is very common and has diagnostic, therapeutic and prognostic implications. The cardiac manifestations of chronic obstructive pulmonary disease are numerous. COPD affects pulmonary blood vessels, right ventricle as well as left ventricle leading to the development of pulmonary hypertension, cor pulmonale, right ventricular dysfunction and left ventricular dysfunction. Because cardiac abnormalities clearly contribute to overall morbidity of COPD, an understanding of their role and potential for treatment is vital. The purpose of this study was to evaluate various cardiac manifestations in chronic obstructive pulmonary disease patients and to observe correlation with its severity. METHODS This hospital based observational study was done in Gauhati Medical College and Hospital attending in-patient department (IPD) and out-patient department (OPD) of Department of General Medicine from 1st July 2018 to 30th June 2019. A total of 140 patients were included in this study. RESULTS Majority of the patients were in the age group of 60 - 70 years. Cardiovascular manifestations were most commonly observed in very severe stage of COPD (GOLD IV). Overall, 91 patients had ECG changes. The most common ECG findings were P pulmonale and right ventricular hypertrophy (RVH). Pulmonary arterial hypertension (PAH) and tricuspid regurgitation (TR) were common echocardiography findings. CONCLUSIONS Cardiac manifestations were more prevalent in COPD GOLD III and IV stages and therefore with increasing severity of COPD, occurrence and severity of cardiac complications becomes more prevalent. ECG and echocardiography are essential investigational tools for diagnosing COPD patients with cardiac complications and assessing their severity. However, a prospective study including a larger sample size is required to arrive at a definite conclusion. KEYWORDS COPD, Cardiac manifestations, ECG, Echocardiography, PAH, RVH","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85020151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile of Neonatal Hypoglycaemia in a Tertiary Care Centre in Mahabubnagar, Telangana","authors":"Nagaveni Patta, Manthena Jagadeesh Kumar, Mohd Sirazuddin","doi":"10.18410/jebmh/2021/589","DOIUrl":"https://doi.org/10.18410/jebmh/2021/589","url":null,"abstract":"BACKGROUND Hypoglycaemia is one of the most common metabolic problems seen in neonatal intensive care units (NICU). Most cases of neonatal hypoglycaemia are transient and respond readily to treatment and are associated with excellent prognosis. Development of clinical signs and symptoms may be a late sign of hypoglycaemia. Persistent hypoglycaemia may result in possible neurologic sequelae. The purpose of this study was to assess the clinical pattern of hypoglycaemia in neonates admitted in special newborn care unit in Government General hospital, Mahabubnagar, Telangana and to also assess the influence of gestational age, birth weight, various comorbid conditions on blood glucose levels. METHODS This is an observational hospital-based study done in Government General Hospital, Mahabubnagar from June 2020 to May 2021. Neonates with hypoglycaemia (blood glucose < 45 mg/dl) at the time of admission are included in our study. Blood glucose values were monitored 2nd hourly on 1st day and 6th hourly thereafter. Following the detection of hypoglycaemia, the neonates were treated as per institutional protocol. Clinical features, laboratory parameters are studied and analysed. RESULTS Among the 99 neonates studied, 68 (68.7 %) were males and 31 (31.3 %) females; Term babies were 75 (75.7 %) and pre term babies were 24 (24.2 %). Low birth weight newborns (51.5 %) were more affected with hypoglycaemia compared to normal weight newborns (38.4 %). Among the 99 neonates studied, 96.9 % were treated and discharged. Average duration of stay was around 05 to 07 days. CONCLUSIONS Hypoglycaemia is most common condition in neonates. Routine screening should be done to all newborns at the time of admission. Timely intervention reduces long term neurological sequelae. Neonates presenting with dull activity, refusal to feed, vomiting, jitteriness, seizures must routinely undergo regular glucose monitoring. As the study shows, most hypoglycaemic neonates presented with those symptoms. Among the various comorbidities, hypoglycaemia occurred more in birth asphyxia and respiratory distress syndrome. So, it should be made mandatory to do glucose monitoring in these cases. Glucose monitoring should be made as a common screening method to prevent morbidity and mortality in neonatal intensive care units. KEYWORDS Hypoglycaemia, Pre-Term, Term, Low Birth Weight, Special New Born Care Unit, Small for Gestational Age, Large for Gestational Age","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82389951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}