Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic

2018 ◽  
Vol 79 (5-6) ◽  
pp. 287-294 ◽  
Author(s):  
Qi Pan ◽  
Yixin Zhang ◽  
Ting Long ◽  
Wei He ◽  
Shanshan Zhang ◽  
...  
Keyword(s):  
Clinical Features ◽  
Outpatient Clinic ◽  
Age Groups ◽  
Tertiary Hospital ◽  
Outpatient Department ◽  
Vestibular Disorders ◽  
Vestibular Diseases ◽  
General Physical ◽  
Medical University ◽  
Paroxysmal Positional Vertigo

Background: Dizziness and vertigo are frequent complaints of outpatients in the neurological department. Our objective was to explore the epidemiological category and clinical features of patients with dizziness or vertigo in the neurological outpatient department of a tertiary hospital. Methods: We consecutively recruited all patients with dizziness and/or vertigo visiting the neurological outpatient clinic of the First Affiliated Hospital of Chongqing Medical University from January 2016 to June 2017. All patients were interviewed by 4 neurologists and they completed self-administered questionnaires. General physical and standardized neuro-otology bedside examinations were performed in all participants. Instrumental examinations and other related examinations were prescribed as needed. Results: A total of 392 patients, 272 female and 120 male, were enrolled and the ratio of males to females was 1: 2.27. The mean age was 52.39 ± 13.87 years (range 11–90). Elderly patients (≥60 years) accounted for about one-third of the patients. Peripheral vestibular disorders accounted for 54.6% of patients, central vestibular disorders (including vestibular migraine [VM]) accounted for 22.4% of patients, psychogenic vertigo in 64 (16.3%), other reasons in 9 (2.3%) and unknown in 17 (4.3%). Benign paroxysmal positional vertigo (BPPV; 30.8%), psychiatric dizziness (20.5%), and VM (14.4%) were the 3 major vestibular diseases in patients under 60 years of age; however, BPPV (27.9%), central vertigo (21.7%), and Meniere’s disease (11.7%) were more common in patients over 60 years of age. Conclusions: This study provided a classification and clinical features of vestibular disorders in a neurological outpatient department of a tertiary hospital in China. The spectrum of vertigo or dizziness is different between different age groups and clinicians should pay attention to this difference in clinical reasoning.

scholarly journals Descriptive study of breast problems in women who present to the general outpatient of a tertiary hospital in eastern region of Nepal

2013 ◽  
Vol 11 (1) ◽  
pp. 33-37
Author(s):  
Rajani Giri ◽  
R Bhandari ◽  
I Mahato ◽  
M Poudel ◽  
S Kumari ◽  
...  
Keyword(s):  
Age Groups ◽  
Breast Disease ◽  
Needle Aspiration ◽  
Tertiary Hospital ◽  
Outpatient Department ◽  
Breast Diseases ◽  
Eastern Region ◽  
Breast Abscess ◽  
Imaging Results ◽  
Needle Aspiration Cytology

Background: Breast problems are common among female patient attending general outpatient. Although the problem is expected to have significant morbidity, patients usually hide or present late for breast related problems in Nepal. Objective: To measure the pattern of breast diseases and its frequency and distribution in different age groups among patients attending general outpatient department at BPKIHS, Nepal. Methods: A crosssectional study was conducted in general outpatient department (GOPD) of B.P.Koirala Institute of Health Sciences (BPKIHS) during a period of six months. Women of all age groups presenting with breast problem were included. Clinical assessment, fine needle aspiration cytology (FNAC) and radiology were done. Mammography being unavailable at the hospital, ultrasonography was the preferred method of imaging. Results: Hundred cases of breast diseases were assessed. The benign breast disease (BBD) was the commonest finding (96%). Among BBD, fibroadenoma was the commonest (32%) followed by breast abscess (26%) and mastalgia (22%) including cyclic and non cyclic. The common age groups of involvement were 30-39 years for fibroadenoma, 20-29 years for breast abscess, 30-39 years for cyclic mastalgia, 40- 49 years for non cyclic mastalgia and 70-79 years for breast cancer. Conclusion: BBD is the most common breast problem in women. Among BBD, fibroadenoma was the most common. Health Renaissance, January-April 2013; Vol. 11 No.1; 33-37 DOI: http://dx.doi.org/10.3126/hren.v11i1.7599

scholarly journals 302 Vestibular Assessment and Rehabilitation within a Day Hospital Falls Assessment Service: Is it Necessary and is it Feasible?

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Micheal McDonnell ◽  
Fiona McGrath ◽  
Tom O'Malley
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Age Groups ◽  
Significant Risk ◽  
Hospital Setting ◽  
Significant Risk Factor ◽  
Vestibular Rehabilitation ◽  
Day Hospital ◽  
Vestibular Disorders ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Abstract Background Benign Paroxysmal Positional Vertigo (BPPV) and other vestibular disorders are very common and often missed in older populations and are a significant risk factor and cause of falls. Vestibular rehabilitation is increasingly recognised as an effective intervention for the management of vestibular dysfunction in all age groups. This review aimed to explore the prevalence of vestibular disorders in the cohort attending an integrated day hospital falls assessment service and the feasibility of delivering vestibular rehabilitation interventions as part of this service. Methods We retrospectively reviewed the charts of all the patients who attended a new ambulatory day hospital between Nov 2018 and April 2019. Inclusion criteria included a recent history of falls and aged over 75. All patients had received a comprehensive geriatric assessment which included screening for vestibular symptoms and on-site assessment (if indicated) by a physiotherapist with expertise in vestibular rehabilitation. Results 40 patients (33 women, 7 men) with a mean age of 82 were seen in this period. All had suffered recent falls with 10 having suffered a fracture. 5 patients (12%) tested positive for Benign Paroxysmal Positional Vertigo and 2 others (5%) had evidence of both peripheral and central vestibular impairment. Vestibular rehabilitation interventions, including particle repositioning manoeuvres were delivered within the day hospital setting with review appointments offered to all patients. Conclusion This review highlights the high prevalence of vestibular disorders, especially BPPV (12%) in older fallers. It supports the feasibility of delivering vestibular assessments and rehabilitation as a component of the physiotherapy input within a day hospital falls service.

To evaluate the efficacy of Jalaukavacharana followed by Khadira Prayoga in Vicharchika w.s.r to Eczema

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Kulkarni Sharad ◽  
Syeda Ather Fathima ◽  
Naveen B. S.
Keyword(s):  
Incidence Rate ◽  
Clinical Features ◽  
Skin Disease ◽  
Skin Disorder ◽  
Age Groups ◽  
High Rate ◽  
Main Line ◽  
Treatment Modalities ◽  
Skin Disorders

Vicharchika (Eczema) is a skin disorder with predominance of Pitta Kapha Dosha, with clinical features like Kandu, Srava, Pidaka, Shyavata, Rookshata, Raji, Ruja and Daha mainly in the extremities. It is the second commonest skin disease affecting all age groups, with incidence rate of 2-3% and high rate of recurrence. Ayurveda emphasizes Shodhana therapy as the main line of treatment in skin disorders. Raktamokshana is indicated as Rakta is mainly involved in Vicharchika. In the present study, two treatment modalities were selected to find out which is more appropriate.

scholarly journals The bucket test reinterpreted: a study on benign paroxysmal positional vertigo and Ménière’s disease patients

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Angel Castro-Urquizo ◽  
Erika Celis-Aguilar ◽  
Guillermo Alejandro Rubio-Partida
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Vestibular Diseases ◽  
Positional Vertigo ◽  
Ménière's Disease ◽  
Paroxysmal Positional Vertigo

Abstract Background The bucket test is a simple and practical instrument to evaluate vestibular diseases; additionally, it could be a useful tool in the evaluation of the vertigo patient. Unfortunately, the bucket test still lacks standardization. The objective of this study was to evaluate and to interpret the subjective visual vertical (SVV) using the bucket test in benign paroxysmal positional vertigo (BPPV) and Ménière’s disease patients. We performed a cross-sectional study in a secondary care center. All patients with diagnosis of unilateral posterior canal BPPV or Ménière’s disease underwent complete neuro-otological physical examination and the bucket test. Normal bucket test was 0° to 3° according to previous study. Results We included seventy-eight subjects. Benign paroxysmal positional vertigo cases (n = 51) showed a mean 2.62° of SVV prior to the Epley maneuver and 1.7° of SVV after the maneuver (p = < 0.001), 57% of patients with BPPV were categorized as abnormal. Inactive Ménière’s disease patients (n = 22) had mean SVV of 2.74° and Ménière’s disease with active crisis (n = 5) had 5.06° of SVV (p = 0.002). Conclusion The bucket test is a simple and useful test for the evaluation of SVV, and it has a role in the evaluation of patients with active vestibular diseases such as Ménière’s disease and BPPV.

scholarly journals Effects of COVID-19 Lockdown on Otitis Media With Effusion in Children: Future Therapeutic Implications

2021 ◽  
pp. 019459982098745
Author(s):  
Mirko Aldè ◽  
Federica Di Berardino ◽  
Paola Marchisio ◽  
Giovanna Cantarella ◽  
Umberto Ambrosetti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Otitis Media ◽  
Outpatient Clinic ◽  
Otitis Media With Effusion ◽  
Tertiary Level ◽  
Vestibular Disorders ◽  
Therapeutic Implications ◽  
History Of ◽  
Clinic Population

Objective To evaluate the role of social isolation during the lockdown due to the SARS-CoV-2 outbreak (severe acute respiratory syndrome coronavirus 2) in modifying the prevalence of otitis media with effusion (OME) and the natural history of chronic OME. Study Design Retrospective study. Setting Tertiary level referral audiologic center. Methods We assessed the prevalence of OME among children aged 6 months to 12 years who attended the outpatient clinic for hearing or vestibular disorders during 2 periods before the lockdown, May-June 2019 (n = 350) and January-February 2020 (n = 366), and the period immediately after the lockdown, May-June 2020 (n = 216). We also compared the disease resolution rates between a subgroup of children with chronic OME (n = 30) who were diagnosed in summer 2019 and reevaluated in May-June 2020 and a similar subgroup (n = 29) assessed in 2018-2019. Results The prevalence of OME in this clinic population was 40.6% in May-June 2019, 52.2% in January-February 2020, and 2.3% in May-June 2020. Children with chronic OME had a higher rate of disease resolution in May-June 2020 (93.3%) than those examined in May-June 2019 (20.7%, P < .001). Conclusion Closure of schools and the physical distancing rules were correlated with a reduction in the prevalence of OME and favored the resolution of its chronic forms among children who attended the outpatient clinic. These data could suggest that in the presence of chronic OME, keeping young children out of group care settings for a period might be beneficial to allow for OME resolution.

Clinical features and therapeutic response in adult and pediatric patients with American tegumentary leishmaniasis in Rio de Janeiro

2019 ◽  
Author(s):  
Tatiana C R Senna ◽  
Maria Inês F Pimentel ◽  
Liliane F A Oliveira ◽  
Marcelo R Lyra ◽  
Mauricio N Saheki ◽  
...  
Keyword(s):  
Clinical Features ◽  
Rio De Janeiro ◽  
Pediatric Patients ◽  
Therapeutic Response ◽  
Age Groups ◽  
Healing Time ◽  
The Body ◽  
Reference Centre ◽  
Tegumentary Leishmaniasis ◽  
American Tegumentary Leishmaniasis

Abstract Background American tegumentary leishmaniasis (ATL) is a neglected disease with wide territorial distribution. Knowledge is scarce in children and adolescents. This study aims to compare the clinical features and response to antimony treatment in pediatric and adult patients with cutaneous leishmaniasis. Methods A retrospective cohort study was performed with 659 patients who attended a reference centre in Rio de Janeiro, Brazil, from 2000 to 2015. The pediatric cohort consisted of 131 (20%) patients and the adult cohort consisted of 528 (80%) patients. Results The epidemiological profile, antimony therapeutic response and incidence of adverse events (AE) were different in the pediatric cohort compared with the adult cohort. Mucosal form was less frequent in the pediatric cohort (RR:0.49, p=0.011). Lesions in the head, neck and trunk were more frequent in the pediatric cohort (RR:1.49, p=0.043). The effectiveness of antimony treatment was superior in the pediatric cohort (88.3% vs 76.6%) with a shorter healing time (RR:0.49, p=0.009). Pediatric patients had lower proportions of moderate to severe AE compared with adults (RR:0.45, p=0.027). Clinical AE predominated in the adult cohort (RR:0.40, p=0.000) and laboratory AE in the pediatric cohort (RR:1.50, p=0.023). Conclusions This study adds to the body of knowledge on differences that exist between different age groups in ATL.

Comparison of clinical characteristics of tuberculosis between two age groups at an Italian Tertiary Hospital

Infection ◽  
2015 ◽  
Vol 43 (3) ◽  
pp. 361-366 ◽  
Author(s):  
Elda Righi ◽  
Paola Della Siega ◽  
Maria Merelli ◽  
Nadia Castaldo ◽  
Anna Beltrame ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Age Groups ◽  
Tertiary Hospital ◽  
Two Age Groups

Epley’s manoeuvre: treatment of choice for benign paroxysmal positional vertigo

2000 ◽  
Vol 114 (11) ◽  
pp. 844-847 ◽  
Author(s):  
Najam-Ul-Hasnain Khan F.C.P.S. ◽  
Mohammad Mujeeb
Keyword(s):  
Prospective Study ◽  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Disorders ◽  
Positional Vertigo ◽  
Epley’S Manoeuvre ◽  
Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is one of the commonest causes of peripheral vestibular disorders. In this prospective study 21 patients with BPPV were treated by Epley’s manoeuvre. All patients had an immediate improvement in their symptoms. Recurrence was noted in three patients who required further treatment sessions with resultant improvement in all. However, one patient who originally had suffered from Me´nie`re’s disease involving the same ear for more than 14 years developed another recurrence which was treated successfully by further application of Epley’s manoeuvre. This study supports the usefulness of Epley’s manoeuvre for the treatment of BPPV.

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