scholarly journals Etiology and risk factors among young patients presenting with stroke in a tertiary care hospital in South India

2017 ◽  
Vol 5 (3) ◽  
pp. 1027
Author(s):  
Thiagaraj Subburaj ◽  
Subramaniyan Kumarasamy ◽  
Sundaravadivelu Velayudam
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Traumatic Injury ◽  
Young Patients ◽  
General Medicine ◽  
Abrupt Onset ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Causes Of Disease

Background: Stroke is one of the leading causes of disease and death throughout the world with the incidence rising steeply with age. The occurrence of stroke in young is rare but once it occurs the outcome is severe. Limited studies have been performed in the Indian population to describe the clinical presentation and etiology of young adults with stroke. The objective of present study is to assess the etiology, risk factors and clinical presentation among patients who visit a tertiary care centre with a clinical diagnosis of stroke in individuals less than 45 years of age.Methods: Consecutive patients visiting the Dept of General Medicine & Neurology, SRM Hospital aged between 15-45 years with abrupt onset of focal or global neurological deficit attributable to vascular cause and persisting for more than 24 hours were included into the study. Patients with traumatic injury and transient ischemic attack were excluded. The clinical features, laboratory and radiological investigations were obtained from the patient’s records.Results: The mean age of the study group was 36.42±6.92 years. The most common risk factor amongst study subjects was smoking (36%). Hemiplegia was more commonly seen in males (38 vs. 14 %, p= 0.26) than in females. Seizures were more commonly seen among subjects with hemorrhagic stroke and cortical venous thrombosis (p= 0.001). Among   subjects with ischemic stroke, the most common etiology was hypercoagulation. The most common arterial territory involved was Middle cerebral artery territory 84.84% with the  Left MCA (53.5%) being  more common than right MCA (46.4%).Conclusions: The clinical presentation and etiology among young patients with stroke appear to remain consistent with that reported earlier in the literature. The paucity of rare presentations of stroke in our study could be attributable to the limited sample size of our study. 

scholarly journals Clinical profile and risk factors for mortality among COVID-19 inpatients at a tertiary care centre in Bengaluru, India

2021 ◽  
Author(s):  
Yamini Marimuthu ◽  
Radhika Kunnavil ◽  
NS Anil ◽  
Sharath Burugina Nagaraja ◽  
N Satyanarayana ◽  
...  
Keyword(s):  
Risk Factors ◽  
South India ◽  
Linear Models ◽  
Tertiary Care ◽  
Male Gender ◽  
Clinical Profile ◽  
Rank Test ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre

COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19.  This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention.  Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.

scholarly journals A clinico-histopathological review of ovarian masses at a tertiary care centre

2018 ◽  
Vol 7 (10) ◽  
pp. 4139
Author(s):  
Michelle N. Fonseca ◽  
Madhavi J.
Keyword(s):  
Tertiary Care ◽  
Young Patients ◽  
Mucinous Cystadenoma ◽  
Reproductive Age ◽  
Care Hospital ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Benign Ovarian Tumours ◽  
Ovarian Tumours ◽  
Ovarian Masses

Background: Ovarian tumours can be seen at all stages of life but they differ in type, being mostly germ cell tumours in childhood, functional cysts in the reproductive age group (up to 45 years) and becoming increasingly malignant towards and after menopause. It also accounts for most prevalent cause of hospital admissions.Methods: This is a retrospective study conducted in the Department of Obstetrics and Gynaecology at a tertiary care hospital in Mumbai from August 2017 to August 2018. All patients with ovarian masses who were surgically managed were included in the study. The data of 30 patients was collected in excel sheet and analyzed by descriptive statistics.Results: Out of the 30 ovarian masses, 50 % were functional cysts, 46.6% were benign ovarian masses and 3.3% were borderline malignant. 46% of tumours were seen in the age group 21-30 years. More than 50 % tumours were seen in parous women. Most common presenting clinical symptom was pain in abdomen irrespective of the type of tumour. Most common complication was haemorrhage in the cyst. Laparoscopy was done in 4 patients and 26 required exploratory laparotomy. Most common surgery performed was unilateral cystectomy for functional ovarian cysts and benign ovarian tumours. Mucinous cystadenoma was the most common benign ovarian tumour, followed by dermoid cyst.Conclusions: Pre-operative diagnostic approach to a patient with ovarian mass includes careful history taking, thorough clinical examination, ultrasound and tumour marker assays in selected cases. Conservative surgery should be the goal to preserve fertility in young patients with ovarian tumours.

scholarly journals Risk factors and coronary angiographic profile in young STEMI patients: results from a tertiary care centre in south-central India

2021 ◽  
Vol 10 (1) ◽  
pp. 111
Author(s):  
Abhishek Golla ◽  
Parvaiz Kadloor ◽  
Rajashekar R. Gurrala ◽  
Kazi Jawwad Hussain ◽  
Kolli Sivadayal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Tertiary Care ◽  
Young Patients ◽  
Tertiary Care Centre ◽  
Circumflex Artery ◽  
Younger Patients ◽  
Left Circumflex Artery ◽  
South Central ◽  
2D Echocardiography

Background: Compared to older counterparts, a significant distinction has been found related to risk factors, clinical presentation, and prognosis of ST-segment elevation myocardial infarction (STEMI) in younger patients. To date, a lack of studies has been looked, specifically at-risk factors and angiographic profile of STEMI among younger patients; with this in mind, we conducted the present study.Methods: This hospital-based, cross-sectional, open-label study was carried out at Deccan College of Medical Sciences between April 2018 and December 2019. Patients under 40 years with the presentation of STEMI were included. All patients were subjected to electrocardiography, 2D echocardiography, and coronary angiogram. Baseline demographics, risk factors, and procedural characteristics were recorded.Results: Of 51 young STEMI patients, 41 (80.4%) were male and 10 (19.6%) were female. The most common risk factors associated with the development of STEMI in young patients were smoking (58.8%), followed by diabetes (45.1%), and dyslipidaemia (45.1%). Anterior wall MI was the most frequent presentation (84.3%). The left anterior descending artery was the most frequently (62.8%) involved vessel, followed by left circumflex artery (9.8%), and right coronary artery (5.9%).Conclusions: Insights gained from the study can aid in identifying clinical characteristics of STEMI in young patients, which may be beneficial to achieve appropriate and timely management. Further, the young population should be educated as to control modifiable risk factors and smoking cessation to prevent coronary artery disease since they belong to the highly productive group in the community.

scholarly journals Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1289
Author(s):  
Murali Thandavarayan ◽  
Sureshkumar Ramaswamy ◽  
Priyadarsini Bose ◽  
Sivaraman Thirumalaikumarasamy
Keyword(s):  
Risk Factors ◽  
Status Epilepticus ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Time Of Arrival ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Medical College

Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children. 

scholarly journals A retrospective study of ectopic pregnancy at a tertiary care centre

2017 ◽  
Vol 6 (12) ◽  
pp. 5241 ◽  
Author(s):  
Archana Mehta ◽  
Shehla Jamal ◽  
Neerja Goel ◽  
Mayuri Ahuja
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Tubal Pregnancy ◽  
Tertiary Care Centre ◽  
Future Fertility ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.

scholarly journals A Clinical Study of Ectopic Pregnancies in a Tertiary Care Hospital of Chittagong, Bangladesh

2014 ◽  
Vol 13 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Most. Sabina Yeasmin ◽  
M Jalal Uddin ◽  
Enamul Hasan
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Clinical Presentation ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
History Of

Background: Motherhood, an eternal, universal and inherent dream which every woman has. This dream may not always be pleasant and it can involve nightmares. One of this is ectopic pregnancy: A pregnancy which can be life threatening. Aims : 1. To know the age group, parity, gestational age and the risk factors with re-spect to the ectopic pregnancy. 2. To know the clinical presentation of the ectopic pregnancy. 3. To know the treatment and morbidity and mortality associated with ectopic pregnancy.Materials & methods : A total of 47 admitted patients who were di-agnosed as ectopic pregnancy cases were retrospective analyzed between the periods from January 2013 to June 2014 at Chattagram Maa-O-Shishu Hospital Medical College, Agrabad, Chittagong. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultrasonogram and at surgery and morbidity associated with ectopic pregnancy were noted.Results: The incidence of the ectopic pregnancy in the pres-ent study was 7.4/1000 deliveries. A majority of the cases were multigravidas and majority of the cases gestational age were six to ten weeks. In most of the cases, there were no identifiable risk factors. The commonest risk factors present were history of MR (12.7 %)and abortion (10.6), history of tubal surgery (2.2%), infertility (2.2%) and pelvic inflammatory diseases (4.2%).The commonest symptoms were abdominal pain (89.3%), amenorrhea (78.7%) and abnormal vaginal bleeding (63.5%); and commonest signs were abdominal tenderness (70.5%), cervical excitation (52.6%) and adnexal tenderness (50.4%). Almost half (45%) were in a state of shock at admission. Ultrasound, a urine pregnancy test and serum B-hCG were the investigative modalities which were used. Surgery by open method in the form of salpingectomy (92.3%), salpingo-oophorectomy (5.5%) and salpingostomy (2.1%) were the mainstay of management. Morbidity included anemia (50.9%), blood transfusion (78%) and wound infection (2.1%). No maternal mortality noted.Conclusion: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.20993  

scholarly journals Prevalence and risk factors of acid peptic ulcer disease at a tertiary care hospital

2018 ◽  
Vol 5 (4) ◽  
pp. 988
Author(s):  
Manohar Shankarrao Chavan ◽  
M. Bhaktavatsalam
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
General Medicine ◽  
Control Measures ◽  
Outpatient Department ◽  
Care Hospital ◽  
Coffee Intake ◽  
Peptic Disease ◽  
Number Of Patients ◽  
Very High

Background: In day to day practice, at outpatient department of General Medicine, at Mahavir Institute of Medical Sciences, Vikarabad, Telangana, India authors are coming across a significant number of patients with acid peptic disease (APD). This prompted us to carry out the present study. The objective is to study the prevalence, risk factors of acid peptic disease and to give suitable recommendationsMethods: Present study was hospital based cross sectional study carried out at outpatient department of General Medicine for a period of ten months from June 2017 to March 2018 among 307 outpatients.Results: The prevalence of acid peptic disease was found to be very high in the present study i.e. 38.1%. This was very high compared to the available literature. The prevalence of acid peptic disease was significantly associated with increasing age, lower social class, alcohol use, tea use and NSAID use. Acid peptic disease was not found to be associated with sex, residence, literacy, smoking, coffee intake, and obesity.Conclusions: Prevalence of acid peptic disease was found to be very high in the present study. Hence there is a need to institute the preventive and control measures to bring down the prevalence. At the same time the people in the surroundings should be made aware of this health problems and its risk factors.

scholarly journals Sex differences in clinical presentation in acute MI

2017 ◽  
Vol 4 (4) ◽  
pp. 940
Author(s):  
Ashwin Kodliwadmath ◽  
Naren V. Nimbal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Chest Pain ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Group ◽  
Care Hospital ◽  
Acute Mi

Background: Acute myocardial infarction differs in women and men with respect to risk factors and clinical presentation. There are studies carried out worldwide on this issue but few from India. This study was done to study the sex based differences in the risk factors and clinical features of acute MI in patients with Indian ethnicity.Methods: Comparative prospective study consisting of 100 women as study group and 100 men as control group with acute MI, who were admitted in a tertiary care hospital, from December 2016 to June 2017.Results: Chest pain was the main complaint in majority of the women (82%) and men (88%). Radiation of chest pain (87%) and sweating (90%) were significantly present in men compared to women (65% and 62% respectively), while breathlessness was significantly present in women (78%) compared to men (64%) and fatigue in women (76%) significantly more than men (55%). Smoking was a significant risk factor in men (69%) compared to women (5%), while diabetes mellitus was a significant risk factor in women (62%) compared to men (39%).Conclusions: Women with acute MI had more atypical presentation of symptoms, similar risk factors, compared to men except for smoking which was more significant in men and diabetes more common in women.

scholarly journals Clinical Profile of Acute Myocardial Infarction at King Abdulaziz University Hospital in Jeddah, Saudi Arabia

2019 ◽  
Vol 9 (2) ◽  
pp. 19-26
Author(s):  
Maryam A. Maryam A. Jabali ◽  
Rana A. Nabalawi Nabalawi ◽  
Ibtihal O. Alsahabi ◽  
Maram F. Almutairi ◽  
Fatimah I. Alsannat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Saudi Arabia ◽  
Tertiary Care ◽  
Young Patients ◽  
Clinical Profile ◽  
University Hospital ◽  
Care Hospital ◽  
King Abdulaziz University

Objectives: This study aimed to assess the clinical profile of myocardial infarction in a tertiary care hospital in Saudi Arabia, and to determine the differences in presentation, risk factors, complications, and mortality between old and young patients. Methods: Retrospective analysis of demographic and clinical data of adult myocardial infarction patients treated in King Abdulaziz University Hospital between 2010 and 2018. Results: A total of 543 acute myocardial infarction patients (79.4% males) were included in the analysis. There were 64 patients aged ≤ 45 years and 479 patients aged > 45 years. The most common presenting symptom was chest pain in both groups. Current smoking was the most common risk factor in the younger group, whereas diabetes mellitus and hypertension were the most common risk factors in the older group. On electrocardiography, ST-elevation myocardial infarction was more common in the younger group. Mitral regurgitation, followed by congestive heart failure, were the most common complications in both groups. The overall mortality rate was low, but it was higher in the older group. Conclusion: Risk factors and electrocardiogram findings differ significantly between younger (≤ 45 years) and older (> 45 years) patients. Smoking cessation must be stressed in young adults. Population awareness regarding the modifiable risk factors of myocardial infarction could help in decreasing its incidence.

scholarly journals Study of risk factors of acute respiratory infections in children admitted in a tertiary care hospital of Southern Maharashtra

2017 ◽  
Vol 4 (9) ◽  
pp. 3129
Author(s):  
Alka C. Kaware ◽  
Nitin H. Kamble ◽  
S. K. Mangulikar
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
High Morbidity ◽  
Acute Respiratory Infections ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
History Of ◽  
Tract Infections

Background: Acute respiratory infections (ARI) is an important cause of mortality and morbidity in children. In India, it constitutes 15% of under five deaths. Various risk factors are responsible for ARI in children. Study of risk factors will help to reduce the high morbidity and mortality due to ARI. The objectives were to study risk factors responsible for acute respiratory infections in children and to find out case fatality rate &/ outcome of acute respiratory infections ARI in children.Methods: A hospital based cross sectional study was done in 2013-14 in a tertiary care centre to study the risk factors associated with ARI in children. All the pediatric patients between 0-12 years admitted in a tertiary care centre at Solapur were enrolled in the study.Results: Acute respiratory tract infections (ARI) were more common in 1-4 years age group i.e. 57.31% (196). It was more common in males i.e. 64.33% (220) than females i.e. 35.67% (122). ARI was more common in lower socio-economic classes i.e. class V (50.58%), class IV (22.52%); in patients whose mothers were illiterate 43.28% and who had history of parental smoking 84.21%. Maximum patients of ARI were having history of overcrowding 75.73%, inadequate cross-ventilation 81.87% and use of smoky chullah 78.65% in their home. Statistically significant association found between ARI cases and these socio-demographic factors. 46.78% (160) were incompletely immunized and 16.37% (56) were not immunized at all. Only 36.84% (126) were completely immunized for their age. Maximum cases of ARI (50.88%) occurred in winter season followed by rainy season (26.90%). Outcome showed that 91.52% (313) were cured, while 1.75% (6) patients died due to ARI.Conclusions: The present study has identified various socio-demographic, nutritional and environmental risk factors for ARI which can be prevented by effective health education and an appropriate initiative taken by the government.

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