Study of the prevalence of isolated vitamin B12 deficiency related dementia in patients presenting to a tertiary care hospital

Background: Objective of the study was to determine the prevalence of Isolated B12deficient dementia in patients presenting to a tertiary care hospital. The MMSE was much lower in B12 deficiency compared to irreversible causes Thus, shorter duration, severe dementia, focal neurological signs, and a vegetarian diet were significantly associated with the development of B12 deficiency.Methods: Based on exclusion and inclusion criteria 100 patients were included in this study, a detailed history of the patient were taken with respect to duration of dementia and its symptoms, type and treatment. Study in terms of the correlation of the clinical features with investigations and diet. Estimation of the prevalence of dementia with reference to B12 deficiency. Mean MMSE analysis, assessment of the improvement in MMSE after treatment with B12 injections after a6-8 wks period.Results: In this study most of our patients were in the 60-69 age groups across all causes of dementia, 22out of 26, B12 deficient patients were vegetarians. This value was in keeping with the known fact that a vegetarian diet predisposes a person to develop B12 deficiency. The association between B12 deficiency, high MCV and megaloblastic blood picture in peripheral blood smear was significant. The MMSE scores were significantly lower 13.42 in patients with B12 deficiency as compared to those with Alzheimer's 14.3 means and those with multi-infarct state 17.3 means.Conclusions: The duration of the presentation in B12 deficiency was10-12months averagely. There was a significant improvement in MMSE after treatment in pureB12 deficient patients (by 9 points) if they presented within one year of symptoms. Except for myelopathy, there was an improvement in other neurological symptoms and signs. Early diagnosis and proper treatment can make improvements in a patient's memory and quality of life.

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Profile of Vitamin B12 Deficiency and Analysis of Contributory Factors among Inpatients in a Tertiary Care Hospital in Madurai, South India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/550 ◽

2020 ◽

Vol 7 (46) ◽

pp. 2674-2679

Author(s):

Vairapraveena Ramesh ◽

Sangeetha Ashokan ◽

Anu Sengottaiyan ◽

Vijay Anto James

Keyword(s):

Vitamin B12 ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Vitamin B12 Deficiency ◽

Cooking Methods ◽

Care Hospital ◽

Contributing Factors ◽

History Of ◽

B12 Deficiency

BACKGROUND It is well known that Vitamin B12 deficiency is common among vegetarians as Vitamin B12 is obtained predominantly from animal sources. However, recent reports show that Vitamin B12 deficiency is becoming more common among nonvegetarians too and surprisingly the major factor attributing to this is found to be due to dietary deficiency. We hypothesized that this could also be due to the type of non-vegetarian food consumed, cooking methods, type of utensil used, and other modifiable risk factors like smoking, alcohol and diseases causing Vitamin B12 deficiency. We wanted to assess the proportion of vegetarians and nonvegetarians with vit. B12 deficiency and analyse the contributing factors among inpatients with vitamin B12 deficiency in a tertiary care hospital in South India. METHODS This observational, prospective study was done between June and September 2019 & involved 200 Vitamin B12 deficiency patients in the age group of 20 - 50 years of both the genders. Patients were identified after reviewing their medical records and laboratory tests for MCV, MCH, MCHC, Hb & vitamin B12. A detailed history of their food habits, practices & other relevant factors was obtained using a questionnaire. Statistical analysis was done using Mann Whitney U test. RESULTS There was no statistical difference (p = 0.379) in the vitamin B12 levels among vegetarians and non-vegetarians. 54.6 % of participants consumed poultry, 32.5 % consumed fruits & vegetables less than 4 times a week, 36 % & 42 % consumed fried & boiled food, 58 % used ever-silver vessels for cooking, 70.6 % used packaged milk, 23 % consumed alcohol & 21 % were smokers. CONCLUSIONS Vitamin B12 deficiency is common both among vegetarians and non-vegetarians. Among non-vegetarians, deficiency is seen more with poultry eaters, packaged milk consumers, with fried / boiled method of cooking using ever-silver vessels. Alcoholism, caffeinated beverages, smoking, presence of other diseases like diabetes, hypertension, peptic ulcer, drug intake also contributes to Vitamin B12 deficiency. KEYWORDS Vitamin B12 Deficiency, Non-Vegetarians, Vegetarians, Contributing Factors

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Psychiatric Illnesses among the Patients Admitted for Self-poisoning in a Tertiary Care Hospital of Nepal

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v2i1.7630 ◽

2013 ◽

Vol 2 (1) ◽

pp. 10-13 ◽

Cited By ~ 1

Author(s):

Ajay Risal ◽

Pushpa Prasad Sharma ◽

Rajkumar Karki

Keyword(s):

Tertiary Care Hospital ◽

Organophosphorus Compounds ◽

Care Center ◽

Tertiary Care ◽

Psychiatric Evaluation ◽

Care Hospital ◽

Age Group ◽

Psychiatric Illnesses ◽

History Of ◽

One Year

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630

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A study of surgical profile of patients with hemorrhoids at a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20190824 ◽

2019 ◽

Vol 6 (3) ◽

pp. 916

Author(s):

Prashant R. Shinde ◽

Meghraj J. Chawada ◽

Sudhir B. Deshmukh

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Vegetarian Diet ◽

Cross Sectional Study ◽

Care Hospital ◽

Age Group ◽

Cross Sectional ◽

Normal Limits ◽

Skin Tag ◽

One Year

Background: In hemorrhoids, the anal canal venous plexuses become engorged. It can lead to bleeding, thrombosis, prolapse, pain. Study of surgical profile helps to educate the patients to take proper precautions to avoid the severe forms of it. The objective of the study was to study the surgical profile of patients with hemorrhoids at a tertiary care hospital.Methods: Present study was hospital based cross sectional study. It was carried out at a tertiary care hospital in the department of general surgery among 100 patients who presented with symptoms suggestive of hemorrhoids during the study period from 1st January 2017 to 31st October 2018.Results: Majority of the patients 41% were in the age group of 35-45 years. The number affected by hemorrhoids was more in males i.e. 56%. Incidence of hemorrhoids was more in upper class. Incidence of hemorrhoids was less i.e. 21% among those who took only vegetarian diet. Majority of the patients (78%) presented after one year of occurrence of treatment. 54% of the patients had third grade of hemorrhoids. Bleeding was present in the majority i.e. 98% of the patients. On anorectal examination, it was found that 44% of the patients had fissure and 23% of the patients had peri anal skin tag. Anorectal examination was within normal limits in 33% of the cases.Conclusions: Vegetarian diet may be protective against hemorrhoids. Bleeding was the most common presenting symptom. Thus, study helped to identify that being male, younger age group, non-veg diet may be the risk factors for hemorrhoids.

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Foreign Bodies in Ear, Nose and Throat: An Experience from a Tertiary Care Hospital in Central Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v21i4.27616 ◽

2019 ◽

Vol 21 (4) ◽

pp. 276-282

Author(s):

Apar Pokharel

Keyword(s):

Foreign Bodies ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Age Groups ◽

Care Hospital ◽

Throat Region ◽

Central Nepal ◽

And Gender ◽

One Year ◽

Nose And Throat

Foreign bodies are frequently encountered otorhinolaryngology emergency. The objective of this research paper is to analyze different foreign bodies in terms of type, site, age, and gender distribution and methods of removal. A retrospective study was performed from March, 2018 to March, 2019 in a tertiary care hospital in the central part of Nepal. The information was obtained from hospital record books. A total of 315 patients visited the hospital with a foreign body in either of their ear, nose or throat. It comprised of approximately 12% of all the ENT emergencies in the hospital in the last one year of study. Foreign bodies in ear, nose and throat region were found in all age groups, although it was more prevalent among children of age group less than 10 years.

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Clinicohematological profile of pancytopenia: a study from a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20200662 ◽

2020 ◽

Vol 7 (3) ◽

pp. 478

Author(s):

Rakesh Kumar Yadav ◽

Sujit Kumar

Keyword(s):

Vitamin B12 ◽

Tertiary Care Hospital ◽

Megaloblastic Anemia ◽

Tertiary Care ◽

Vitamin B12 Deficiency ◽

Clinical Feature ◽

Study Group ◽

Care Hospital ◽

Female Ratio ◽

B12 Deficiency

Background: Pancytopenia is common clinical condition which we encounter in our daily clinical practice. Pancytopenia is characterized by decrease in all the three major components of blood like Red Blood Corpuscles, White blood Corpuscle, and platelets. This study was carried out to look for causes of pancytopenia and clinical presentations at tertiary care hospital in north India.Methods: The study was conducted at MLN Medical College, Allahabad in the Department of Medicine between June 2018 to July 2019. Total 125 patients who attended department of medicine were screened for study. After exclusion 94 patients were studied prospectively.Results: Out of 94 patients 59 were males, and 35 females in the study group. Male to female ratio was 1.6:1. Maximum patients were between 20 years to 35years of age group. Pallor and weakness were most common clinical feature in this study group. Out of various etiological causes vitamin B12 deficiency was the commonest in our study. 48(51%) patients had megaloblastic anemia due to vitamin B12 deficiency. Second most common etiological factor was hypo plastic/aplastic anemia. Other etiological abnormalities were hypersplenism, dengue, malaria, sepsis, myelodysplastic syndrome and multiple myeloma.Conclusions: Bone marrow examinations, aspiration cytology or biopsy are important tool for diagnosis of pancytopenia. Underlying cause and severity of disease determine the outcome of pancytopenia. The present study concluded that most of patients with pancytopenia have treatable cause so early diagnosis will be helpful for management of patients.

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