scholarly journals Strategies to cope claustrophobia during magnetic resonance imaging examination

2019 ◽  
Vol 7 (4) ◽  
pp. 1166
Author(s):  
Syed Amir Raza Zaidi ◽  
Kamran Masood ◽  
Usman Khanzada ◽  
Syed Omair Adil ◽  
Munawar Hussain
Keyword(s):  
Tertiary Care ◽  
Magnetic Resonance Imaging Examination ◽  
P Value ◽  
Care Hospital ◽  
Diagnostic Modality ◽  
Effective Strategies ◽  
Education Status ◽  
Set Up ◽  
A Prospective Study ◽  
Short Intervention

Background: Claustrophobia associated with MRI scan is a well-recognized problem all over the world. The unpleasant psychological experience during MRI can lead to premature cancellation of the study resulting in non-interpretable data. In addition, performing future studies on the claustrophobic patient may not be possible leading to non-utilization of an important diagnostic modality. This study was conducted with the aim to determine a cheap and short intervention which can be applicable to small radiology set up as well.Methods: A prospective study was conducted at a tertiary care hospital from October 2016 to December 2016. Accompanying someone was the first strategy used to coped MR imaging claustrophobia followed by placebo (multivitamin), listening Quran and closed eye (blindfold). All those patients who failed to respond in these strategies were finally labeled as an unsuccessful candidate. Listening of Quran was selected as one of the tools as all the patients were Muslims in present study.Results: Among 84 claustrophobic patients, a closed eye was the most successful strategy found effective in (13) 81.2%, followed by placebo 66.7% patients, listening Quran (7) 30.4%, accompanying someone (15) 17.85% while 4% patients remained claustrophobic after application of all strategies. Significant association of accompanying someone and placebo was observed with education (p-value 0.037) and age of the patients (0.016) respectively.Conclusions: In general, placebo, being accompanied by someone and blindfold were found to be the most effective strategies to cope with MRI related claustrophobia. However, the success of these strategies is also dependent on certain factors like age, education status and socioeconomic status of the patients.

scholarly journals A two-year study on postmenopausal bleeding at a tertiary institute

2021 ◽  
Author(s):  
Sowmyanarayanan Lavanya ◽  
Swetha Munivenkatappa ◽  
Anthata Jyothsna Sravanthi
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Age Distribution ◽  
Developed Countries ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Postmenopausal Bleeding ◽  
Medical Problems ◽  
Set Up ◽  
A Prospective Study

Background: The life expectancy of women shows an increase as a result of which women experience a long postmenopausal phase. Postmenopausal bleeding is a worrisome symptom occurring in 10 % of the women, making them seek a gynaecology opinion at the earliest. Women in developed countries have a predilection for developing endometrial cancer whereas cancer cervix still dominates in the developing countries. This prospective study was carried out on 75 women presenting with postmenopausal bleeding to the gynaecology clinic at a tertiary hospital set up. The study aimed to find the incidence of postmenopausal bleeding, age distribution, causes and different evaluation methods to confirm the diagnosis.Methods: The present study is a prospective study conducted on 75 postmenopausal women reporting with postmenopausal bleeding at the gynaecology clinic at a tertiary care hospital.              Results: Menopause was noted above 45 years in 84% of the patients and 16% were in 40-45 years age. Postmenopausal bleeding was observed in 50-60 years in 56% of women and 30% above 60 years. The medical problems associated were hypertension (20%), diabetes (11%), obesity (22%), hypothyroidism (4%). 53 women had benign causes while 22 had malignancy.Conclusions: Benign lesions of the genital tract are common causes of postmenopausal bleeding. Carcinoma cervix and endometrium classically present with postmenopausal bleed. Strong suspicion, thorough evaluation and early diagnosis improve the quality of life and reduce the morbidity and mortality.

scholarly journals Risk factors for ectopic pregnancy; an institutional study in a tertiary care hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4741
Author(s):  
Ranjita Ghadei ◽  
Swayamsiddha Mohanty ◽  
Sushree Sovana Mishra ◽  
Debashis Giri
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Previous History ◽  
Diagnostic Tools ◽  
P Value ◽  
Care Hospital ◽  
Pregnancy Risk ◽  
History Of ◽  
A Prospective Study

Background: Ectopic pregnancy is the leading cause of maternal death during the 1st trimester of pregnancy, accounting for approximately 10% of all pregnancy related deaths. A better understanding of ectopic pregnancy risk can help prevent its occurrence. The present study was designed to evaluate the ectopic pregnancy risk factors and their strength of association with ectopic pregnancy at a tertiary care hospital.Methods: It was a prospective study with 104 cases of ectopic pregnancy and 125 controls conducted in the Department of Obstetrics and Gynecology, SCB Medical College, Cuttack for a period of 1 year. Detailed history suggestive of risks factor for ectopic pregnancy, menstrual and obstetrics history was taken. General, systemic, abdominal and vaginal examination was done. Diagnosis of ectopic pregnancy was confirmed by clinical examination, urine pregnancy test, ultrasonography and culdocentesis and only confirmed cases were included in the study group. Healthy pregnant women were taken as control group.Results: The study revealed that the risk of ectopic pregnancy was associated with the traditional risk factors including previous EP [Adjusted odds ratio (AOR) = 9.98, 95% CI: 0.89-11.1%], previous infertility (AOR= 7.29, 95% CI:2.53-21.0) and previous history of sterilization (AOR=12.47,95% CI: 3.50 - 44.4) and previous history of abortion (AOR= 3.10, 95% CI: 1.53-6.30). Age comparison between cases and controls revealed that the ODDS of having ectopic pregnancy was 4 times in the age group 30 to 35 years as compared to uterine pregnancy and this difference was statistically significant (P value = 0.007).Conclusions: Risk factors such as previous ectopic pregnancy, induction of ovulation, intra uterine device usage, abortion as well as increased maternal age along with recent diagnostic tools aid in early detection of ectopic pregnancy in women resulting in proper and timely treatment.

scholarly journals Efficacy and safety of radiofrequency ablation for lower limb varicose veins

2018 ◽  
Vol 5 (11) ◽  
pp. 3676
Author(s):  
Anushtup De ◽  
Prabal Roy ◽  
Sunil Kumar
Keyword(s):  
Radiofrequency Ablation ◽  
Varicose Veins ◽  
Tertiary Care ◽  
Clinical Severity ◽  
P Value ◽  
Care Hospital ◽  
Vein Thrombosis ◽  
Venous Clinical Severity Score ◽  
The Mean ◽  
A Prospective Study

Background: Endovenous Radiofrequency Ablation (RFA) is gradually gaining widespread acceptance as a minimally invasive modality for treatment of varicose veins (VV). The objective of this study was to evaluate the efficacy based on Venous Doppler and Venous Clinical Severity Score (VCSS) and the safety of radiofrequency ablation for varicose veins.Methods: This is a prospective study of 58 consecutive patients who underwent Radiofrequency ablation of Varicose veins from January 2015 to January 2017 in a single unit of a Multispecialty Tertiary Care Hospital. The mean age was 44.10±13.74 years (19-75 years). A total of 78 limbs were treated in 58 patients. RFA was performed using Closure FastTM catheter according to the manufacturer’s recommendation. Treatment outcomes were estimated 15 days, 3 months, 6 months and 1 year after the procedure using Doppler scan and VCSS score.Results: There was 100% occlusion of the treated veins with no evidence of partial/complete recanalization. However, 2 (2.56%) patients had a GSV stump length > 3cm on Doppler at 6 months, without evidence of significant reflux. Minor complications such as ecchymosis erythema, pain and induration rapidly improved over short term. One patient (1.3%) had evidence of Deep Vein thrombosis (DVT) on follow up Venous Doppler. The mean VCSS improved from mean of 7.98 preoperatively to 2.24 after 1 year (P value <0.001).Conclusions: Radiofrequency ablation is a safe and effective procedure with minimal major complications. The minor complications were early and resolved rapidly.

scholarly journals A Prospective Study of Evaluation and Management of Obstructive Jaundice in a Tertiary Care Hospital, North Coastal Andhra Pradesh

2021 ◽  
Vol 8 (21) ◽  
pp. 1717-1721
Author(s):  
Janni Laxman ◽  
Patnala Mohan Patro
Keyword(s):  
Obstructive Jaundice ◽  
Analytical Study ◽  
Tertiary Care ◽  
Average Diameter ◽  
P Value ◽  
Care Hospital ◽  
Medical Sciences ◽  
Malignant Obstructive Jaundice ◽  
Painless Jaundice ◽  
A Prospective Study

BACKGROUND Obstructive jaundice is defined as a condition occurring due to block in pathway between the site of conjugation of bile in liver cells and entry of bile into duodenum through the ampulla. This block may be intraheptic or extraheptic in the duct. Evaluation and management of obstructive jaundice is a challenging task to the surgeon owing the varied etiology and wide management option. Common bile duct (CBD) varies in length from 5 to 15 cm with average diameter of 6 mm. CBD can be divided in to four portions: supra duodenal, retro duodenal, intra duodenal and intramural portion. The purpose of this study was to evaluate the pattern of aetiology of obstructive jaundice in these parts and compare the clinical and laboratory presentations with obstructive jaundice between benign and malignant cases. METHODS This is a prospective analytical study. Patients with obstructive jaundice who attended the outpatient department of Surgery, GITAM Institute of Medical Sciences and Research, Visakhapatnam over a period of 24 months from November 2017 to October 2019 were admitted and taken up for the study. A total of 60 cases were studied. RESULTS Abdominal pain was a presenting symptom in 48 patients (80 %). Ninety five percent of patients of benign and 50 % of patients of malignant aetiology presented with this symptom. P value was found to be statistically significant for this symptom. This means that jaundice with pain in abdomen is more common in benign conditions while malignant conditions cause painless jaundice. CONCLUSIONS Malignant obstructive jaundice is most commonly seen in males while benign conditions are more common in females. Benign conditions causing obstructive jaundice is most common under 40 years of age while malignant obstructive jaundice is commonly seen between 50 and 60 years of age. KEYWORDS Cholestasis, Extraheptic, Obstructive Jaundice

scholarly journals Study of biochemical parameters of atherosclerosis male patients in tertiary care hospital of Rewa, Madhya Pradesh, India

2018 ◽  
Vol 6 (7) ◽  
pp. 2401
Author(s):  
Drutpal Singh Baghel ◽  
Adesh Patidar
Keyword(s):  
Biochemical Parameters ◽  
Tertiary Care Hospital ◽  
Blood Clot ◽  
Tertiary Care ◽  
Western World ◽  
P Value ◽  
Care Hospital ◽  
Male Patients ◽  
Student’S T ◽  
A Prospective Study

Background: Atherosclerosis is characterized by intimal lesions called atheromas or atheromatous or fibro fatty plaques which protrude into and obstruct vascular lumens and weaken the underlying media. Global in distribution, atherosclerosis over whelming contributes to more mortality approximately half of all deaths and serious morbidity in the Western World than any other disorder. The atherosclerotic plaque is a lumpy thickening of the arterial wall, narrows the passage way and initiates the formation of a blood clot that can ultimately close down a critical artery. The objective of the study was to comparative biochemical parameters in different age group of atherosclerosis male patients.Methods: It was a prospective study, conducted in department of medicine of tertiary care hospital at Rewa. 30 atherosclerotic patients were selected for this study on the basis of inclusion and exclusion criteria, Biochemical testing was done for all patients and data of biochemical parameters were reported as the Mean±SD. Results were performed by the unpaired student’s t-test.Results: Total 30 atherosclerosis male patients and 27 normal healthy male volunteers were enrolled for the study. Biochemical parameters of both of this group were compared with t-test and p-value was found significant.Conclusions: Risk factors such as elevations in body mass index, systolic blood pressure, serum LDL cholesterol, triglyceride concentration and cigarette smoking are significantly related to the extent of atherosclerotic lesions.

scholarly journals Acute exacerbations of asthma occurring frequently time to check your techniques

2019 ◽  
Vol 6 (6) ◽  
pp. 1755
Author(s):  
Vijaysagar Reddy Bonapelli ◽  
Sujay D. J. ◽  
Prakruthi J. ◽  
Sathiqali A. S.
Keyword(s):  
Tertiary Care ◽  
Severity Index ◽  
Inhalation Therapy ◽  
Lower Grade ◽  
Care Hospital ◽  
Strong Negative Correlation ◽  
Inhalational Technique ◽  
Set Up ◽  
A Prospective Study ◽  
Inhalational Therapy

Background: Asthmatics form a predominant section of patients in OPD. If poorly controlled the frequency of attacks requiring an emergency department visit adds to the burden. It was noticed that the patients who were on inhalational therapy had poor control despite the absence of other factors which could lead to exacerbations. Hence author evaluated the inhalational techniques.Methods: A prospective study undertaken in the department of medicine  in tertiary care hospital in Dakshina Kannada District, Karnataka enlisting 25 patients admitted with acute exacerbation of bronchial asthma. The patients were assessed for their symptoms, signs and recurrent attacks along with their cough severity index and inhaler scores and the observations were tabulated.Results: Of the twenty-five, 15 were on inhalation therapy with various modes of deliveries. There were 15 males and 10 females from ages 20 to 50years. The number of attacks of asthma was higher in those not on inhalation therapies than those using inhalation therapies. Also, the level/severity of cough, measured as Cough Severity Index, was assessed among the two groups. Those on inhalation therapy had a lower grade of cough than those not on therapy . Mean AEC was 94 among those on inhalation therapy and 209 among those not on therapy. Inhalational score was calculated for each patient. There is a strong negative correlation of -0.709 between inhalation score and recurrent attacks, which is statistically significant (p=0.003). Lower inhalation scores were associated with recurrent attacks.Conclusions: Recurrent exacerbations in an asthmatic patient on inhalation therapy are due to improper inhalational technique. It was suggested that it is wise to spend time with the patients in authors OPD set up and teach them the correct techniques of using inhalational therapy hence reducing frequency of attacks and cost of health care in such patients.

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.

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