scholarly journals Clinical and investigational study for the aetiological evaluation of patients in nontraumatic altered sensorium and its outcome

2019 ◽  
Vol 7 (4) ◽  
pp. 1113
Author(s):  
Siba Narayan Jali ◽  
Sachida Nanda Nayak ◽  
Biju K. Alexander ◽  
Diptimayee Tripathy ◽  
Bijaya K. Behera
Keyword(s):  
Tertiary Care ◽  
General Medicine ◽  
Diagnostic Methods ◽  
P Value ◽  
Care Hospital ◽  
College Hospital ◽  
Metabolic Encephalopathy ◽  
Altered Sensorium ◽  
Medical College ◽  
Gcs Score

Background: Apart from head injury many patients present to the tertiary care hospital in unconscious state, the etiology of which is obscure in most of the cases. The present study was conducted with on objective to provide insight into the clinical features and diagnostic methods to know the aetiology of patients with non-traumatic cases of altered sensorium and to study the outcome of these patients.Methods: This is an observational study on 100 patients of altered sensorium of non-traumatic origin during the period from October 2012 to September 2014 conducted in the Department of General Medicine, MKCG Medical College Hospital, Berhampur, Odisha, India. All patients were selected for the study based on the inclusion exclusion criteria. Detailed history, clinical evaluation, laboratory investigations like neuroimaging studies etc. were carried out. Statistical data analysis was done using Graph pad Prism 6 and Microsoft Excel. P value <0.0001 was considered statistically extremely significant.Results: Out of 100 patients of altered sensorium, 64 were males and 36 were females. All patients were in the age group of 19 to 89 years. Cerebrovascular accident was the most common aetiology of altered sensorium followed by metabolic encephalopathy and infection. Altered sensorium in patients with CVA carries a high mortality. Metabolic causes and younger age indicated a better prognosis, patients with low (Glasgow Coma Score) GCS score of 3 to 4 had poorer prognosis.Conclusions: The results suggest that clinical assessments yield accurate predictive information about the potential for recovery in cases of altered sensorium. So, this study concludes that empirically based estimates of prognosis in the neurologically severely ill provides great reassurance to those involved in a decision-making process, including patients’ families and physicians.

scholarly journals Clinico-pathological Correlation with Liver Enzymes in Dengue Infection

2017 ◽  
Vol 27 (Number 2) ◽  
pp. 27-30
Author(s):  
A H M Kamal ◽  
K H Mollah ◽  
K E Khuda ◽  
A Lslam ◽  
N Sultana ◽  
...  
Keyword(s):  
Liver Enzymes ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
P Value ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Hepatic Involvement ◽  
Atypical Manifestations

Dengue infection is a major vector borne disease. The classical signs and symptoms include high fever, severe headache, chill, and rash. Atypical manifestations of dengue infection with hepatic involvement are frequently reported, ranging from mild elevations of liver enzymes to acute liver failure. Analysis of 110 serologically confirmed cases of dengue infection in Holy Family Red Crescent Medical College hospital a tertiary care hospital was done. Patients with normal aminotransferase levels were categorized into Grade A, patients with at least one of the enzymes raised above normal but less than 3 times were categorized into Grade B, those with at least one of the enzymes elevated more than 3 times but less than 10 times were graded as C, and those with elevations more than 10 times as Grade D. 83.7% patients had alterations of transaminase levels, with 45.5% categorized into grade b, 30.9% into grade C, and 7.3% into grade D or acute hepatitis (P value 0.224). Rise of aspartate aminotransferase (AS7) levels were higher compared to the levels of alanine aminotransferase (AL7). Liver damage with alteration of aminotransferases is a common manifestation of dengue infection and also valuable markers for monitoring these patients.

scholarly journals Bacterial Contamination of Stethoscope in a Tertiary Care Hospital

2018 ◽  
Vol 30 (2) ◽  
pp. 1-6
Author(s):  
Md Azizul Haque ◽  
Khandaker Md Faisal Alam ◽  
Laila Shamima Sharmin ◽  
Atike Mahmud ◽  
MM Washee Parvez ◽  
...  
Keyword(s):  
Bacterial Contamination ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Medical College Hospital ◽  
P Value ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Bacterial contamination of stethoscope and its role in transmission of nosocomial infection is little known among the healthcare workers of Bangladesh. The objectives of our study is to evaluate stethoscope handling and cleaning practices, to find out the bacterial agents contaminating the stethoscopes, to determine the antibiotic sensitivity patterns of bacterial isolates from stethoscopes, and to evaluate the relationship between stethoscope cleaning practices with contamination of stethoscope in Rajshahi Medical College Hospital. This observational cross sectional study was carried out in Rajshahi Medical College Hospital during March, 2017. One hundred doctors working in different departments of RMCH were chosen randomly and were asked to fill up a self-explanatory simple questionnaire. Samples from100 stethoscopes were obtained after swabbing the diaphragm and the bell of the stethoscope with a sterile swab moistened with saline. These swabs were immediately streaked onto blood agar, Mcconkey agar and chocholate agar following the standard protocol. Out of 100 stethoscopes examined for bacterial contamination, 19 stethoscopes (19%) were found to be contaminated. The organisms isolated were MRSA, pseudomonas aeruginosa, and E. coli. Among the 19 participants with bacterial contamination of stethoscope, 6 doctors (31.6%) said they used to clean their stethoscope at least occasionally and 13 doctors (68.4%) had never cleaned their stethoscope. This difference was found to be statistically significant (p value <0.005).TAJ 2017; 30(2): 1-6

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

2020 ◽  
Keyword(s):  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Traumatic Head Injury ◽  
Keywords Epilepsy ◽  
College Hospital ◽  
Cross Sectional

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.

scholarly journals Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1007
Author(s):  
Vijoy S. Kairi ◽  
Pinaki Chakravarty ◽  
Arun Kumar Sipani
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Case Record ◽  
Medical College ◽  
Disease Modifying ◽  
Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

scholarly journals VAGINAL DISCHARGE

2011 ◽  
Vol 18 (04) ◽  
pp. 598-603
Author(s):  
SHAHIDA SHAIKH ◽  
SALEEM AKHTER SHAIKH ◽  
INAYAT MAGSI
Keyword(s):  
Vaginal Discharge ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital ◽  
Internally Displaced ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Medical College ◽  
Abnormal Growth ◽  
History Of

Objective: To observe the results of syndromic management in women living in IDPs camps complaining of chronic vaginal discharge. Design: Descriptive study. Setting: Medical Camps at Larkana set by Chandka Medical College Hospital for Internally Displaced Persons (IDPs) due to floods. Period: 1st September 2010 to 31st December 2010. Material and Methods: Total 200 symptomatic patients aged from 20 to 50 years suffering from chronic vaginal discharge having history of more than 6 months duration were included in the study. Asymptomatic as well as pregnant women and patients with abnormal cervix and having abnormal growth on cervix were excluded from the study. A detailed history and examination (including speculum and vaginal) was done and a proforma was filled. All these patients were given empirical treatment recommended by WHO as syndromic management consisting of stat doses of antifungal along with antibiotics, where no laboratory tests are required before treatment. Results: Next to vaginal discharge which was main symptom in all patients, the other symptoms like dusparunia, dysuria, itching ,lower abdomen pain and low backache was reported 9%, 16%, 20%, 24% and 31% respectively. Also 8% patients reported post coital bleeding. All patients were married and the mean age of the patients was 28+0.2 years and 15% of them were over 40 years. Mean parity was 4±1.Vaginal infection improved in 65% of the patients excellently with a first line single course of antibiotic and percentage raised up to 88% with second course. 19(9.5%) patients couldn’t be followed as they left that camp and 5(2.5%) patients who did not improve with two courses of antibiotics had big cervical erosions, referred to nearby tertiary care hospital for further management. Conclusions: IDPs live in poor conditions in camps without basic facilities and where it is difficult to perform bedside tests like microscopy, Potassium Hydroxide, wet mount films and tests for Sexually transmitted diseases like Chlamydia and gonorrhea are not available, syndromic management there is a rational way of treating cases of chronic vaginal discharge to get quicker response in such desperate women. 

scholarly journals Satisfaction of women with health service provider in outpatient department of Obstetrics and Gynecology at a Tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Ashia Khatun ◽  
Khairun Nahar ◽  
Mst Nurunnahar Aktar ◽  
Fatema Mahbooba Akter ◽  
Habibur Rahman
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospital Environment ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Health Service Provider ◽  
College Hospital ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Medical College

Background: Patient's satisfaction over the health care services is very important issue in Bangladesh.Objective: The purpose of present study was to find out the level of satisfaction of women attending in the OPD of Obstetrics and Gynecology department at a tertiary care hospital in Dhaka.Methodology: This descriptive type of cross sectional study was carried out in the OPD of Obstetrics and Gynecology department at Dhaka Medical College from September 2011 to October 2011 for a period of one month. All the women attending in Obstetrics and Gynecology department in outdoor service at Dhaka Medical College Hospital, Dhaka with the age group of 22 to 40 years were selected as study population. A purposive sampling method was used to collect the data.Results: A total number of 200 cases were taken for this study. Highly satisfied over the services delivered by the doctors was reported in 135 (65.8%) cases and service of nurses was satisfied 111(55.8%) of cases. Satisfactory waiting time (two hours) was 143(7l.9%) of cases and the satisfactory hospital environment was 127 (63.8%) of cases.Conclusion: In conclusion most of the women are satisfied to the treatment delivered by the doctors at the OPD of a tertiary care hospital.J Shaheed Suhrawardy Med Coll, 2014; 6(2):79-81

scholarly journals Socio-demographic Characteristics of Vesico-vaginal fistula (VVF) patients attended at a tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Medical College Hospital ◽  
Care Hospital ◽  
Vaginal Fistula ◽  
College Hospital ◽  
Medical College ◽  
The Mean ◽  
Vesico Vaginal Fistula

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117

scholarly journals Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

2013 ◽  
Vol 3 (1) ◽  
pp. 29-31
Author(s):  
Swapna Bhattacharjee ◽  
Shekhar Bhattacharjee ◽  
Rukhsana Parvin
Keyword(s):  
Chronic Cough ◽  
Tertiary Care ◽  
Complete Recovery ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Cough Variant Asthma ◽  
Medical College

Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31

scholarly journals Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female ◽  
Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

scholarly journals Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Before And After ◽  
A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

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