scholarly journals Seizures in patients with respiratory disease - a retrospective single center study

2020 ◽  
Vol 78 (5) ◽  
pp. 247-254
Author(s):  
Senay AYDIN ◽  
Cengiz ÖZDEMIR ◽  
Ayşegül GÜNDÜZ ◽  
Meral E. KIZILTAN
Keyword(s):  
Tertiary Care ◽  
Previous History ◽  
Respiratory Acidosis ◽  
Care Hospital ◽  
Group I ◽  
Chest Clinic ◽  
History Of ◽  
Symptomatic Seizures ◽  
Group Ii ◽  
History Of Epilepsy

ABSTRACT Objective: Seizures are a neurological condition commonly experienced during the follow-up period after systemic or metabolic disorders. The aim of the present study was to determine the etiological factors of seizures in patients at a tertiary care chest clinic. Methods: We reviewed all neurology consultations that were requested due to seizures in inpatient clinics in a tertiary care hospital specializing in respiratory disorders between January 2011 and January 2018 were retrospectively reviewed. Results: The present study included 705 of 2793 (25.2%) patients who requested consultations for seizures during the study period. The mean age of the sample was 64.05±17.19 years. Of the 705 patients, 307 (43.5%) had a previous history of epilepsy (Group I) and 398 (56.5%) had a first-time seizure and were considered to have symptomatic seizures (Group II). Multiple factors played roles in the development of seizures in 54.8% of the patients. In most patients, metabolic causes, systemic infections, and drug use were identified and an intracranial metastatic mass lesion was the major cause in patients with lung cancer. Rates of hypoxemia and respiratory acidosis were significantly higher in patients with symptomatic seizures (Group II) than in patients with primary epilepsy (Group I). Conclusions: Blood gas changes such as hypoxemia and respiratory acidosis were among the factors statistically associated with the development of symptomatic seizures in patients with respiratory diseases. Additionally, hypoxemia, hypercapnia, and respiratory acidosis were correlated with mortality in patients hospitalized for respiratory system diseases who requested consultations for seizures.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Prevalence of anaemia among children under five years in tertiary care hospital of Nepal.

2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Care Hospital ◽  
Cross Sectional ◽  
Children Under Five ◽  
Group Iii ◽  
Under Five ◽  
Group I ◽  
Group Ii

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998

scholarly journals A randomised trial of 5% minoxidil versus combination of 5% minoxidil and oral spironolactone in treatment of female pattern hair loss

2019 ◽  
Vol 5 (4) ◽  
pp. 668
Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu
Keyword(s):  
Combination Therapy ◽  
Hair Loss ◽  
Tertiary Care ◽  
Randomised Trial ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Female Pattern Hair Loss ◽  
Group I ◽  
Topical Minoxidil ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>

scholarly journals A study on risk factors, maternal and foetal outcome in cases of preeclampsia and eclampsia at a tertiary care hospital of South India

2017 ◽  
Vol 7 (1) ◽  
pp. 266
Author(s):  
Bandaru Sailaja ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Sailcheemala ◽  
Surayapalem Sailaja
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Care Hospital ◽  
History Of ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.

scholarly journals A comparative study of tapentadol versus tramadol in the treatment of low back pain

2020 ◽  
Vol 9 (7) ◽  
pp. 1064
Author(s):  
Laxman Verma ◽  
Pankaj Kumar Chaudhary ◽  
Chandresh Gupta ◽  
Umesh Saroj
Keyword(s):  
Pain Intensity ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Assessment ◽  
Group I ◽  
Parallel Group ◽  
Reduction Of Pain ◽  
The Mean ◽  
Group Ii ◽  
The Difference

Background: Nontraumatic musculoskeletal disorders are the main reason for presentation to the emergency department with Rachialgia being the most common reason to request medical assessment among them. Methods: This was a prospective, randomized, parallel group open labelled study conducted in a district level tertiary care hospital attached to a medical teaching institute. Patients were randomized into two groups. Group I (63 patients) received tablet tramadol 50 mg twice daily orally and group II (63 patients) received tablet tapentadol 50 mg twice daily orally.Results: The mean age of the patients of group I was 40.6±9.6 years and in the group II was 42.7±10.6 years. A total of 61 males participated in the study of which 31 males were enrolled in group I and 30 in group II while 65 females participated in the study of which 32 females were enrolled in group I and 33 in group II. The mean reduction of pain intensity VAS score at the end of 4 weeks from baseline in group I and group II were 34.57 and 37.55 respectively. The difference in the mean reduction of pain intensity VAS between the two groups was not statistically significant.Conclusions: We conclude that both the drugs show significant reduction in the pain intensity in moderate to severe CLBP patients. Tapentadol is as efficacious as tramadol in moderate to severe CLBP. However, tapentadol is better tolerated than tramadol.

scholarly journals Effect of Povidone Iodine Versus Chlorhexidine Mouthwash on Oral Mucositis among Cancer Patients

2021 ◽  
Author(s):  
. Jyothi ◽  
S Latha ◽  
K Pavithra ◽  
M Nalini ◽  
Sowmya J Rao ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Cancer Patients ◽  
Oral Mucositis ◽  
Povidone Iodine ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Group I ◽  
Grading Scale ◽  
Group Ii

Introduction: Radiation therapy and chemotherapy are the standard treatment given for cancer, which leads to the variety of adverse effects of which Oral Mucositis (OM) is one of the common side-effects. It is responsible for patient discomfort and decreases their level of functioning. Both Chlorhexidine and Povidone Iodine have got antimicrobial and antifungal activity which decreases the severity of mucositis. Aim: To compare the effectiveness of Povidone Iodine and Chlorhexidine mouthwash on OM among cancer patients undergoing radiation therapy or chemotherapy. Materials and Methods: A prospective observational study was conducted in the tertiary care hospital of Mangaluru, Karnataka, India for the duration of one year and three months from December 2015-March 2017. Fifty cancer subjects aged between 25 to 65 years and who developed OM after radiation therapy or chemotherapy were selected by purposive sampling technique. Data were collected using the demographic profile, clinical proforma and World Health Organisation (WHO) OM grading scale (2004) from 19.09.2016 to 17.12.2016. Experimental group I received 10 mL of diluted Povidone Iodine mouthwash and group II received 10 mL of diluted chlorhexidine mouthwash. Level of OM in the group I and group II were assessed on the 1st, 3rd, 5th and 7th day using WHO OM grading scale (2004). The data were analysed by descriptive and inferential statistics (Wilcoxon signed- rank test, Mann-Whitney U test, Repeated measures ANOVA) using SPSS version 16.0. Results: Among the 50 cancer subjects, majority 30 (60%) were in the age group between 55-64 years and majority 35 (70%) were receiving radiation therapy. On day seven, in the group I (Povidone Iodine) majority 14 (56%) subjects had mild level of mucositis whereas in the group II (Chlorhexidine) majority 14 (56%) subjects had moderate mucositis. Comparison of the effect of Povidone Iodine and Chlorhexidine mouthwash using Friedman’s ANOVA showed that there was a difference in the level of mucositis (p<0.05) at 5% level of significance among two groups. The study findings also revealed a difference in the level of mucositis between day 1 to day 3, 5 and 7 (Mann-Whitney U test) (p<0.05) in both the groups. Conclusion: Povidone Iodine mouth wash was more effective than Chlorhexidine mouthwashes in reducing OM, and the patients were more comfortable after the use of the mouthwash.

scholarly journals Prevalence of hepatitis C among haemodialysis patients in a tertiary care hospital in South India

2020 ◽  
Author(s):  
Anitha Madhavan ◽  
Arun Sachu ◽  
Anu Kumar Balakrishnan ◽  
Anu Vasudevan ◽  
Sobha Balakrishnan ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Blood Transfusion ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Previous History ◽  
Antibody Detection ◽  
Hcv Rna ◽  
Care Hospital ◽  
History Of ◽  
Hcv Antibody

Background and Objectives: Hepatitis C is the most common hepatotropic viral infection that affects patients on mainte- nance hemodialysis. Most of the laboratories in India depend on HCV antibody detection by ELISA. PCR based studies on detection of HCV RNA among haemodialysis patients are very scanty in India. The current study was undertaken to find the prevalence of HCV among haemodialysis patients by ELISA and PCR. Materials and Methods: This prospective study was conducted from January to May 2018 in a total of 100 samples. Patients more than 18 years of age, who had undergone at least 15 sessions of dialysis were enrolled in the study. All samples were screened for HCV antibody by ELISA and HCV RNA by PCR. Data regarding age and gender of the patients, history of blood transfusion, duration of hemodialysis, total bilirubin levels were collected from medical records. Results: Among the 100 samples, only one was positive for HCV antibody by ELISA. Eight samples were positive for HCV RNA by PCR. In this study 62.5% of the HCV positives had a previous history of blood transfusion. Duration of dialysis was more among the HCV positive group but there was no statistical significance. Conclusion: This is the first study from the southern state of Kerala in India showing the prevalence of HCV among hemo- dialysis patients by PCR. Our study showed an overall HCV prevalence of 8% by PCR. All the PCR positive samples were negative by 3rd generation ELISA which is an alarming finding and further justifies the need for PCR for detecting HCV.

scholarly journals Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Wajid Jawaid ◽  
Muhammad Irfan ◽  
Sundus Mehtab Shafee ◽  
Sidra Javed Barry ◽  
Sayed Mustafa Mahmood Shah ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Status Epilepticus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Male Gender ◽  
Care Hospital ◽  
Factors Affecting ◽  
Cns Infections ◽  
History Of

Objectives: This study aimed to evaluate the etiology, outcomes and prognostic factors associated with status epilepticus (SE) admissions in Neurology Department of a tertiary care hospital. Methods: A retrospective review was performed on all SE admissions at Dr. Ruth K.M. Pfau Civil Hospital Karachi over a five-year period from July 2015 to June 2020. Demographic, clinical, and etiological factors were investigated for prognostic value. Statistical tests were applied to determine significant prognostic factors. A five percent significance level was used. Results: A total of 176 patients were included in the study. Mortality was reported in 22 cases (12.5%) and morbidity at six months was observed in 44 cases (25.0%). Male gender, previous history of SE, prolonged seizure duration, and late presentation to hospital were significantly associated with mortality (p<0.05). De novo cases of SE tended to be older (p=0.048) and were associated with morbidity at follow-up (p=0.000). The most common causes of epilepsy in our patients with SE were CNS infections (n=54) and Idiopathic epilepsy (n=34). Non-compliance to medicines/under-dosing was the most common provocative factor (n=68). Acute symptomatic causes of SE were more likely to be associated with greater morbidity (p=0.000). Refractory and super-refractory SE were strongly associated with higher mortality (p=0.000). A longer duration of hospital stay was associated with higher morbidity (p=0.000). Conclusion: Male gender, poor control of seizures, CNS infections, prolonged seizures, delayed hospital arrival and refractory/super-refractory status epilepticus were key determinants of mortality in our setting. Previous history of status epilepticus, and acute and symptomatic etiologies were associated with higher morbidity. doi: https://doi.org/10.12669/pjms.38.1.5195 How to cite this:Jawaid W, Irfan M, Shafee SM, Barry SJ, Shah SMM, Shahbaz N. Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.5195 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Obstetric and neonatal outcome in women with a history of recurrent miscarriage at tertiary care hospital, Karnataka: a retrospective cross-sectional study

2018 ◽  
Vol 7 (2) ◽  
pp. 648 ◽  
Author(s):  
Chintan Upadhyay ◽  
Nisha Upadhyay
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Tertiary Care ◽  
Previous History ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
History Of

Background: When clinical pregnancy is established, the risk of spontaneous pregnancy loss is ~12-14%, and therefore the incidence of Recurrent Pregnancy Loss (RPL) by chance alone would be in the order of 0.35%. It occurs in 0.5-3% of women. The objective of this study was to evaluate the obstetric outcome in pregnancies with history of one or more abortions.Methods: It is a retrospective cross-sectional study done at Obstetrics and Gynecology Department, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore. Record review of cases was done from January 2005 to December 2009. Inclusion criteria were pregnancies with history of previous abortions.Results: There were 400 cases with previous history of abortions. There were 266 (66.4%) booked cases while 134 (33.5%) were unbooked cases. 272 (68.0%) patients crossed viable period of pregnancy (more than 28 weeks). Around 56 (14.0%) cases had repeat abortions, 276 (69.0%) cases underwent vaginal delivery and 124 (31.0%) underwent cesarean section. Almost 91 (22.8%) of Babies were low birth weight while others were above 2.5 kg. There were 52 (13.0%) preterm babies and 28 (7.0%) Intrauterine demise of fetuses.Conclusions: Patients with previous history of abortions are at increased risk of adverse maternal and perinatal outcome.

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