scholarly journals Clinical profile of patients of poisoning admitted in emergency department in a teaching hospital, MAMC, Agroha, Haryana, India

2017 ◽  
Vol 5 (8) ◽  
pp. 3767
Author(s):  
Mohd Y. Shah ◽  
Mohd M. Naqash ◽  
Faisal Y. Shah ◽  
Faizan Y. Shah
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Agricultural Land ◽  
Suicide Attempts ◽  
Family Members ◽  
Clinical Profile ◽  
Precipitating Factors ◽  
Number Of Patients ◽  
Catchment Areas ◽  
History Of

3 Million Serious poisoning (1 million accidentals and 2 million suicide attempts) occur each year worldwide.1 India ranks second in Asia in annual pesticide consumption.2 A study was conducted (1 year) wherein patients with history of poisoning were admitted from different catchment areas of hospital (30 Km radius). The total number of patients admitted during study period was 61. Patients had consumed these agents to attempt suicide. Out of 61 patients 26 were male and rest 37 were females. 18 patients died and rest survived. The precipitating factors in the suicide attempts were stranded relations with husband/wife, failure in examination and confrontation with parents. The availability of these poisonous substances in the household make people to consume these agents on slight provocation.3 All our patients, though majority were literate, were from families who had agricultural land and majority of their family members were farmers. Table 1 and Table 2 depict the characteristics and clinical profile of 61 patients admitted during the study period.

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

Prevalence of and Risk Factors for Suicide Attempts Among Patients With Severe Psychiatric Disorders in Eastern Morocco

Crisis ◽  
2021 ◽  
Author(s):  
Mohammed Barrimi ◽  
Khalid Serraj ◽  
Ismail Rammouz ◽  
Rachid Alouane ◽  
Najoua Messaoudi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Suicide Attempt ◽  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Personal History ◽  
University Hospital ◽  
Number Of Patients ◽  
History Of ◽  
Risk Factors For Suicide

Abstract. Background: Suicide attempts are common in patients with severe psychiatric disorders; however, they are rarely studied in this population. Aims: To investigate the prevalence and risk factors associated with suicide attempts among patients with severe psychiatric disorders. Method: This is a cross-sectional study of patients admitted to the Mohammed VI University Hospital of Psychiatry in Oujda, Morocco. Results: A total of 250 patients with a psychiatric disorder were recruited in this study. Among these, 78 cases (31.2%) had a personal history of suicide attempts. A personal history of suicide attempt was significantly higher among women compared to men (45.5% vs. 27.2%, p = .0099). The most common method of suicide attempts was jumping from heights (31%). Patients with a personal history of suicide attempts had a significantly higher prevalence of alcohol consumption ( p = .0063), family history of psychiatric disorders ( p = .002), family history of suicide attempt ( p = .00004), and family history of suicide ( p = .018) compared to those who had never made suicide attempts. Limitations: As suicidal behavior is highly stigmatized in Morocco, the number of patients who have made a suicide attempt may be underestimated. Conclusion: Our findings justify the need to provide specialized support to psychiatric patients with risk factors for suicide attempts.

scholarly journals Do not attempt resuscitation orders at the emergency department of a teaching hospital

2017 ◽  
Vol 15 (4) ◽  
pp. 409-414 ◽  
Author(s):  
Cássia Regina Vancini-Campanharo ◽  
Rodrigo Luiz Vancini ◽  
Marcelo Calil Machado Netto ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Meiry Fernanda Pinto Okuno ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiopulmonary Resuscitation ◽  
Teaching Hospital ◽  
Past History ◽  
Advanced Age ◽  
Fisher Exact Test ◽  
Resuscitation Orders ◽  
Cross Sectional ◽  
Initial Rhythm ◽  
History Of

ABSTRACT Objective: To identify factors associated with not attempting resuscitation. Methods: A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05). Results: No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole. Conclusion: Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.

scholarly journals Clinical Profile of Patients with Seizure in Kathmandu Medical College Teaching Hospital.

2019 ◽  
Vol 8 (2) ◽  
pp. 53-56
Author(s):  
Krishna Dhungana ◽  
Dipesh Shakya ◽  
Rabindra Shrestha ◽  
Sabnam Bhatta ◽  
Sabbu Maharjan
Keyword(s):  
Teaching Hospital ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Medical College ◽  
Number Of Patients ◽  
East Asia Region ◽  
Age And Sex

Background: Seizure is a common clinical condition. It represents a majority of patients visiting neurology OPD as well as inpatient department in Kathmandu Medical College Teaching Hospital. While the number of patients with seizure is increasing in Nepal, data on the clinical profile of patients with seizure is scarce. Thus, this study aims to find out the relative frequency of seizure in different age and sex groups. It also aims to find out the common causes of seizure in our Nepalese population. Materials and Methods: A descriptive cross sectional study was carried out in patients attending outpatient and inpatient of Neurology department of Kathmandu Medical College Teaching Hospital between periods of July 2018 to December 2018. Demographic characteristics, radiographic findings, EEG findings and drugs taken by patients were recorded according to the proforma. Results: Data from one hundred patients were collected and analyzed. Most of the patients were less than 41 years of age. Most of the patients were male. The prime cause of seizure was found to be neurocysticercosis (25%). Majority of the patients were on monotherapy. Conclusion: Our data regarding the frequency of seizure in different age and sex groups is comparable to data in South East Asia region whilst, different from the western data. In our population, neurocysticercosiswas the most common cause of seizures. Also, most seizures were controlled with monotherapy.

scholarly journals Fear of Susceptible to Infectious Disease Experienced among the Hospitalized Patients in the University of Calabar Teaching Hospital, Calabar

2020 ◽  
Vol 6 (2) ◽  
pp. 9-17
Author(s):  
Oyira, Emilia James
Keyword(s):  
Infectious Disease ◽  
Teaching Hospital ◽  
Financial Support ◽  
Communicable Disease ◽  
Family Members ◽  
Hospitalized Patients ◽  
Number Of Patients ◽  
Research Questions ◽  
The University ◽  
Significant Support

This study sought to investigate the fear of susceptible to infectious disease experienced among the hospitalized patients in the University of Calabar Teaching Hospital. Two research questions one hypothesis were used. Do hospitalized patients in University of Calabar Teaching Hospital, Calabar have fear of susceptibility to infectious disease? What support do hospitalized patients in University of Calabar Teaching Hospital, Calabar received from family. The hypothesis states that; there is no significant relationship between fear among hospitalized patients and the support they received from family members. Literature was reviewed based on the research variables. The research instrument used in collecting data for analysis was a questionnaire administered to one hundred (100) hospitalized patients in University of Calabar Teaching Hospital, Calabar. Their responses were analyzed using frequencies, percentages and Pearson product moment correlation analysis and the following results were obtained, Results in Table 3 indicated that 68(68%) of the respondents agreed that they have received a significant support from their family members during the period of their hospitalization while 32(32%) disagreed. 24(24%) said the financial support they received from family members was too minimal while 76(76%) said it was not. 78(78%) agreed that their family members frequently visited them while 22(22%) disagreed. The above data, therefore, showed that hospitalized patients in UCTH, Calabar received both moral and financial support from family members. In line with the views expressed by the patients. It was recommended that more nurses should be employed to help avoid contacting the communicable disease. This implies that, the nurses would be able to manage two patients at a time instead of taking care of a large number of patients.

Acute Alcohol Use, History of Homelessness, and Intent of Injury Among a Sample of Adult Emergency Department Patients

2017 ◽  
Vol 32 (4) ◽  
pp. 658-670 ◽  
Author(s):  
Katelyn K. Jetelina ◽  
Jennifer M. Reingle Gonzalez ◽  
Carlos V.R. Brown ◽  
Michael L. Foreman ◽  
Craig Field
Keyword(s):  
Emergency Department ◽  
Alcohol Use ◽  
Suicide Attempts ◽  
Trauma Centers ◽  
Regression Analyses ◽  
Violent Injury ◽  
Future Studies ◽  
Intentional Injuries ◽  
History Of ◽  
Emergency Department Patients

Background: The literature is clear that adults who are currently homeless also have higher rates of intentional injuries, such as assault and suicide attempts. No study has assessed whether intentional injuries are exacerbated because of substance use among adults with a history of homelessness. Methods: Data were obtained from a cohort of adults admitted to 3 urban emergency departments (EDs) in Texas from 2007 to 2010 (N = 596). Logistic regression analyses were used to determine whether a history of homelessness was associated with alcohol use at time of injury in intentional violent injuries (gunshot, stabbing, or injury consistent with assault). Results: 39% adults with a history of homelessness who were treated at trauma centers for a violent injury. Bivariate analyses indicated that adults who had ever experienced homelessness have 1.67 increased odds, 95% confidence interval (CI) [1.11, 2.50], of any intentional violent injury and 1.95 increased odds (95% CI [1.12, 3.40]) of a stabbing injury than adults with no history of homelessness. Conclusions: Adults who experienced homelessness in their lifetime were more likely to visit EDs for violence-related injuries. Given our limited knowledge of the injuries that prompt ED use by currently homeless populations, future studies are needed to understand the etiology of injuries, and substance-related injuries specifically, among adults with a history of homelessness.

scholarly journals Predictive factors for special care units admission and in-hospital mortality among geriatric patients that presented to the emergency department of a teaching hospital

2018 ◽  
Vol 26 (6) ◽  
pp. 336-342
Author(s):  
Khai Yen Lim ◽  
Nik Hisamuddin Nik Ab Rahman
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Teaching Hospital ◽  
Geriatric Patients ◽  
Inotropic Support ◽  
Special Care ◽  
World Population ◽  
Factors Associated ◽  
Special Care Units ◽  
Number Of Patients

Background: The world population is experiencing ageing and this phenomenon certainly gives significant impact to the social, economic as well as health care services globally. Objectives: This study aimed to determine the prevalence of geriatric patients treated in critical zone in an emergency department of a teaching hospital and the factors associated with special care units admission and in-hospital mortality. Methods: A single-centre prospective cross-sectional study was carried out from 1 January 2016 to 31 December 2016 at the Emergency Department Hospital at Universiti Sains Malaysia, Malaysia. All patients aged 60 years and above were included. Systematic random sampling was used. Variables were analysed using simple and multiple logistic regressions. Results: The total number of patients included in this study was 328, 55.8% were male and the mean age was 70.6 (standard deviation: 7.5) years. The commonly presenting diseases in this study were cardiovascular (31.4%), infectious (29.6%), neurological (14.9%) and respiratory (12.5%). Out of the 328 patients studied, 187 (57.0%) were admitted to general wards and 110 (33.5%) to special care units. A total of 55 patients (16.8%) succumbed within the period of in-hospital treatment. The factors associated with special care units admission were the usage of non-invasive ventilation and the administration of inotropic support. The factors associated with in-hospital mortality were blood urea level, serum albumin level and the application of mechanical ventilation. Conclusion: Geriatric patients who presented to emergency department requiring ventilator and inotropic support had been observed to exhibit worse outcome. The associated factors for special care units admission and in-hospital mortality had been identified, and this will enable better settings cater to the needs for critically ill geriatric patients.

Inpatient Hypercoagulable Work-up in a Community Teaching Hospital: A Preventable Cost with No Added Benefit

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 26-26
Author(s):  
Haritha Ackula ◽  
Shekhar Patil ◽  
Sandhya Maradana ◽  
Masood Pasha Syed ◽  
Ahmad Daniyal Siddiqui
Keyword(s):  
Venous Thromboembolism ◽  
Teaching Hospital ◽  
Conflicts Of Interest ◽  
Hospitalized Patients ◽  
Prior History ◽  
Inherited Thrombophilia ◽  
Number Of Patients ◽  
History Of ◽  
Thrombophilia Testing ◽  
Community Teaching

Background: Thrombophilia testing in hospitalized patients is often inaccurate and rarely clinically useful especially in acute settings. Testing for inherited thrombophilia is often done in the setting of recurrent unprovoked venous thromboembolism (VTE). Several prospective studies have shown that heritable thrombophilia status is not statistically associated with recurrent VTE. Additionally, such testing may be confounded by ongoing disease or treatment. The cost per thrombophilia panel testing range anywhere between $1100 to $2400 based on estimation of charges billed by a large commercial laboratory. We aim to identify patterns and costs involved in inpatient thrombophilia testing in a community teaching hospital. Methods: The study was conducted as a part of our quality improvement initiative in a community teaching hospital. We performed a retrospective chart review of patients above the age of 18 years who had a clinically and radiologically confirmed diagnosis of venous thromboembolism during the year of 2016 and performed descriptive analysis. Institutional IRB was obtained and data was collected by reviewing the electronic medical records . Results: A total of 395 patients with the diagnosis of VTE were included (mean age 68.5, 54.2% female). At least one thrombophilia test was ordered in 66 of the 395 patients (16.7%). Around 38 (9.6%) patients were already on anticoagulation for atrial fibrillation/flutter, deep venous thrombosis (DVT) and pulmonary embolism (PE) among whom 5/38 (13.2%) patients underwent thrombophilia testing. Number of patients with a prior history of DVT or PE or both were 67/395(20%). Out of these, 26/67 (38.8%) patients were on anticoagulation and 14/67 (20.9%)patients underwent thrombophilia testing during their hospital stay. Only 11/395 (2.8%) patients had a family history of DVT/PE among whom 4 were tested. The approximate cost of the testing was $132,000 considering roughly $2000 per test on an average for a total of 66 tests. Discussion: Thrombophilia testing in hospitalized patients adds little if at all any value to their acute management. However, it does add a significant unnecessary avoidable cost to the hospital. Although inpatient thrombophilia testing is not supported by current guidelines for inherited thrombophilia evaluation, the testing is often done in hospitalized patients with recurrent thromboembolism. Learning the pattern of thrombophilia testing in hospitalized patients will help us implement measures to prevent unnecessary testing and the significant costs associated with it. Conclusion: With the increasing emphasis on value-based health care, thrombophilia testing should be considered only if it affects overall patient management and preferably in an outpatient setting with appropriate indications. Disclosures No relevant conflicts of interest to declare.

scholarly journals Factors Associated with Opioid Overdose During Medication-Assisted Treatment: How Can We Identify Individuals at Risk?

2020 ◽  
Author(s):  
Vivian Yin On Au ◽  
Tea Rosic ◽  
Nitika Sanger ◽  
Alannah Hillmer ◽  
Caroul Chawar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Physical Symptoms ◽  
Opioid Overdose ◽  
Multinomial Regression ◽  
Factors Associated ◽  
Medication Assisted Treatment ◽  
Lifetime History ◽  
Number Of Patients ◽  
Increased Risk ◽  
History Of

Abstract Background: Due to the loss of tolerance to opioids during medication-assisted treatment (MAT), this period may represent a time of heightened risk for overdose. Identifying factors associated with increased risk of overdose during treatment is therefore paramount to improving outcomes. We aimed to determine the prevalence of opioid overdoses in patients receiving MAT. Additionally, we explored factors associated with opioid overdose during MAT and the association between length of time enrolled in MAT and overdose. Methods: Data were collected prospectively from 2,360 participants receiving outpatient MAT in Ontario, Canada. Participants were divided into three groups by overdose status: no history of overdose, any lifetime history of overdose, and emergency department visit for opioid overdose in the last year. We used a multivariate multinomial regression model to assess demographic and clinical factors associated with overdose status. Results: Twenty four percent of participants reported a lifetime history of overdose (n=562) and 8% reported an emergency department (ED) visit for opioid overdose in the last year (n=179). Individuals with a recent ED visit for opioid overdose were in treatment for shorter duration (odds ratio [OR] = 0.92, 95% confidence interval [CI] = 0.87, 0.97, p = 0.001). Individuals with a lifetime or recent history of overdose were more likely to be younger in age (OR = 0.93, 95% CI = 0.89, 0.98, p = 0.007 and OR = 0.84, 95% CI = 0.77, 0.92, p <0.001, respectively), report more physical symptoms (OR = 1.02, 95% CI = 1.01, 1.03, p =0.005 and OR = 1.03, 95% CI = 1.01, 1.05, p = 0.005, respectively), and had higher rates of non-prescription benzodiazepine use (OR = 1.87, 95% CI = 1.32, 2.66, p <0.001 and OR = 2.34, 95% CI = 1.43, 3.81, p = 0.001, respectively) compared to individuals with no history of overdose. Conclusions: A considerable number of patients enrolled in MAT have experienced overdose. Our study highlights that there are identifiable factors associated with a patient’s overdose status that may represent areas for intervention. In particular, longer duration in MAT is associated with a decreased risk of overdose.

scholarly journals Evaluation of clinical outcomes of patients with mild symptoms of coronavirus disease 2019 (COVID-19) discharged from the emergency department

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258697
Author(s):  
Hamidreza Morteza Bagi ◽  
Maryam Soleimanpour ◽  
Fariba Abdollahi ◽  
Hassan Soleimanpour
Keyword(s):  
Emergency Department ◽  
Clinical Outcomes ◽  
Emergency Departments ◽  
Demographic Data ◽  
Family Members ◽  
Risk Of Death ◽  
Phone Calls ◽  
History Of Disease ◽  
History Of ◽  
Underlying Diseases

Introduction This study was performed to determine the clinical outcomes of patients with mild symptoms of COVID-19 discharged from the emergency department. Methods The present descriptive-analytical cross-sectional study was performed on 400 patients discharged with a diagnosis of COVID-19 from the emergency departments of hospitals affiliated to Tabriz University of Medical Sciences in the time period of 21 March-21 June, 2020. The disease characteristics and demographic data were collected by phone calls during the first, third, and fourth weeks using a researcher-made questionnaire. Finally, the data were analyzed by univariate logistic regression and cross-tabulation using the IBM SPSS Statistics for Windows, version 20. Results In the first week of follow-up, 23(5.8%) patients died, of whom seven patients were female and 16 were male (mean age of death: 70.73±3.27). Out of 41 (10.3%) patients with underlying diseases, 7 (17.1%) died; but out of 359 (89.8%) cases with no history of disease only 16 (4.5%) died. The risk of death in subjects with a history of underlying diseases was 3.27 times higher than those without a history of disease (P = 0.02) (OR = 3.27, 95% CI, 1.20–8.87); and this risk was 1.41 times higher in patients with more family members (P = 0.04) (OR = 1.41, 95% CI, 1.01–1.97). Furthermore, 81 (20.3%) patients had spread the virus to others in their households and disregarded hygiene guidelines such as washing hands, keeping social distancing, and wearing face masks after discharge. In addition, family members of these patients were 16.37 times more likely to be infected than patients who followed the protocols (P ≤ 0.001) (OR = 16.37, 95% CI, 9.10–29.45). Conclusion Since our findings showed that mortality rate is high in the first week after patients’ referral to the emergency departments, the health status of infected people should be carefully monitored daily in this period.

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