scholarly journals Topical steroids more abused than used! A cross-sectional study in the outpatient department of dermatology in a tertiary care centre in coastal Karnataka

2019 ◽  
Vol 6 (1) ◽  
pp. 57
Author(s):  
Rashmitha Nagaraj ◽  
Shruthi Hassan Nagaraj
Keyword(s):  
Tertiary Care ◽  
Outpatient Department ◽  
Ambulatory Setting ◽  
Topical Steroids ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Clinical Issue ◽  
Topical Corticosteroids ◽  
Rebound Phenomenon

<p class="abstract"><strong>Background:</strong> Topical corticosteroids (TCS) are one among the most commonly prescribed medications in the ambulatory setting. They exhibit anti-inflammatory effects, immunosuppressive effect, antiproliferative effects and vasoconstriction.</p><p class="abstract"><strong>Methods:</strong> A total of 400 patients who had visited the outpatient department or was admitted in the department of dermatology and had applied topical corticosteroids for a duration of 2 or more weeks were included for the study over a period of 2 months in June and July 2018. This study is clinical and observational, to evaluate the topical corticosteroids abuse cases.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 400 people 304 [76%] patients were either recommended or prescribed TCS by a non-physician source. And the rest 96 [24%] patients were been prescribed by the medical fraternity. Majority of patients have applied TCS belonging to super potent class [294/400] duration of usage varied from 2 weeks to 2 years and amount from 10 to 240 g. The most common consequences of TCS abuse was rebound phenomenon followed by hypopigmentation, striae.</p><strong>Conclusions:</strong> Prolonged and continuous use of TCS can cause many adverse effects with varying clinical presentation. Treatment is difficult as there is rebound phenomenon with discontinuation of TCS. Gradual withdrawals of TCS with supplementation of adequate treatment to the present clinical issue are usually recommended to get good clinical results.

scholarly journals Patients’ knowledge of prescribed medication: a cross sectional study in a tertiary care centre, Mumbai

2019 ◽  
Vol 6 (10) ◽  
pp. 4238
Author(s):  
Ashis Samuel John ◽  
Kamaxi M. Bhate
Keyword(s):  
Tertiary Care ◽  
Treatment Compliance ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Study Population

Background: Inadequate understanding by patients of medical prescription given to them adversely affects treatment compliance; which can result in treatment failure and increase the incidence of adverse effects. The study site is a tertiary care hospital in a metropolitan city and the patients attending here are particularly vulnerable in this regard both due to the heavy patient load in the outpatient department and their low socioeconomic status.Methods: This was a cross sectional study conducted in the pharmacy of K.E.M. Hospital, Mumbai over a period of 1 month. Study population included general outpatient department patients of the hospital. Patients were interviewed using a pre validated questionnaire and their knowledge of the prescription analysed under five key aspects including dose, timing, duration, side effects and purpose of each drug. Data was entered using Microsoft Excel and analyzed using SPSS 22 software.Results: The mean age of the population was 37.6, with a standard deviation of 12.4. A good overall knowledge of the prescription was present only in 12.4% patients. In 52% of patients, the level of knowledge ranged from ‘no knowledge to little knowledge’. Age and literacy had statistically significant associations with overall knowledge of prescription.Conclusions: There is a significant gap in prescription knowledge in the study population. Age and literacy of the patient has an effect on prescription knowledge.

scholarly journals Psychiatric Disorders in Adolescents Attending Psychiatry Outpatient Department in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Neelam Joshi ◽  
Asim Shrestha ◽  
Deepika Karki ◽  
Pradip Man Singh
Keyword(s):  
Psychiatric Disorders ◽  
Emotional Disorders ◽  
Psychotic Disorders ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Adolescence is the time when most mental illness begins most of the time these problems are overlooked leading to increased morbidity and mortality. The study is undertaken to find out the prevalence of psychiatric disorders in adolescents attending psychiatry outpatient department in a tertiary hospital. Methods: A descriptive cross-sectional study was done from 1st December 2019 to 29th November 2020 at a tertiary care centre of Kathmandu. Ethical approval (Ref No.: 012-076/077) was taken from the Institution Review Committee. A semi-structured proforma was used for the socio-demographic profile of patients and International Classification of Diseases-10 was used to make the diagnosis. Data were analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 174 adolescents were included in the study. Out of the total cases 141 (81.03%) (75.1-86.8 at 95% Confidence Interval) were diagnosed with psychiatric disorders, among them 73 (51.77%) were males and 68 (48.23%) were females. The common diagnoses were anxiety disorders 63 (36.20%), mood disorders 34 (19.54%), psychotic disorders 26 (14.94%), substance use disorders 8 (4.59%), non-organic sleep disorders 5 (2.87%), behavioral and emotional disorders 3 (1.72%) and mental retardation 2 (1.149%). Conclusions: Prevalence of psychiatric illnesses is high in the adolescent population compared to the similar studies.

scholarly journals Topical steroid abuse on face: a prospective study from a tertiary care centre of north India

2017 ◽  
Vol 3 (3) ◽  
pp. 433
Author(s):  
Asha Nyati ◽  
Anil Kumar Singhal ◽  
Devendra Yadav ◽  
Manoj Kumar Sharma
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Topical Steroid ◽  
North India ◽  
Topical Steroids ◽  
Tertiary Care Centre ◽  
Dermatology Department ◽  
Steroid Abuse ◽  
Topical Corticosteroids

<p class="abstract"><strong>Background:</strong> Topical corticosteroids (TCS) are widely misused on face which is associated with significant adverse effects and poor awareness of these effects. The aim of this study was to assess the frequency of misuse of topical corticosteroids, the causes behind it and the most common adverse events resulting from it and to make aware the people about it</p><p class="abstract"><strong>Methods:</strong> This study was conducted at Dermatology Department of Govt. Medical College, Kota during period of one year from July 2015 to June 2016. A total of 670 patients using topical steroids over face were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients were females (72.68%). The most common reason for misuse was melasma (57. 91%) followed by use as a fairness cream (22.38%). Most of the patient used topical steroid cream for duration of 3-6 months (33.13%). Most common age group was 21-30 years (48.20%). Acne form eruption (38.05%) and rebound erythema (28.20%) were the most common adverse effects noted. Patients were ignorant of the ingredients and their side effects.</p><p class="Default"><strong>Conclusions:</strong> Steroids have been misused by patients on their own or by pharmacist and non-dermatologist physicians for various reasons. Topical steroid should not be used on the face unless it is under strict dermatological supervision. </p>

scholarly journals Maternal near miss: an Indian tertiary care centre audit

2019 ◽  
Vol 8 (5) ◽  
pp. 1874
Author(s):  
Padmaja Y. Samant ◽  
Juhi Dhanawat
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Data Entry ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Near Misses

Background: In practical terms, women are considered near-miss cases when they survive conditions which threaten their life i.e. organ dysfunction. Despite advances in medical science and increased awareness of measures for safe childbirth, unacceptably high maternal morbidity and mortality continues to plague developing countries like India. Our’s being a tertiary care centre, draws a lot number of high-risk patients and referrals. By auditing these near miss cases, we aim to identify the causes, factors leading to near miss, to identify management gaps to prevent near misses and maternal death.Methods: Retro-prospective cross-sectional study done over one and a half year. Patients were included based on the inclusion criteria. A questionnaire was used to evaluate the prospective cases and the indoor case sheets were used for retrospective cases. After data entry in excel sheet, data analysis was done using SPSS 21. Results were tabulated.Results: High number of Near Miss cases with preeclampsia being the commonest. Lack of proper facilities at the periphery health centers was the most common cause for referrals. Level 1 and level 2 delays were found in most cases.Conclusions: Timely referral, with adequate treatment at the peripheral hospitals will majorly reduce Near miss. Hence, proper development and functioning of peripheral hospitals are needed.

scholarly journals Serum vitamin D3 deficiency among cases with extensive tinea corporis infection

2020 ◽  
Vol 6 (6) ◽  
pp. 729
Author(s):  
Karthik Raja S. ◽  
Shahul Hameed G.
Keyword(s):  
Vitamin D3 ◽  
Large Scale ◽  
Tertiary Care ◽  
Serum Vitamin ◽  
Tinea Corporis ◽  
Outpatient Department ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Vitamin D3 Deficiency

<p><strong>Background:</strong> Abnormal serum vitamin D3 levels have been implicated as risk factors for development of various skin disorders. Hence this study was planned to assess the prevalence of vitamin D3 deficiency among patients with <em>Tinea corporis</em> who were attending outpatient department of dermatology in a tertiary care centre.</p><p><strong>Methods: </strong>The cross sectional study was conducted by the department of dermatology, venereology and leprosy, at Sri Muthukumaran Medical College Hospital and Research Institute, among the patients attending the outpatient department, during the month of June to August 2019. A total of fifty cases with extensive <em>Tinea corporis</em> infection were included in the study. The study was conducted using a proforma with the detailed clinical history and also patients underwent skin scrapping for KOH mount and serum vitamin D3 analysis. Data was entered in Microsoft excel and data analysis was done using Statistical Package for Social Sciences (SPSS) version 17.</p><p><strong>Results: </strong>Among the cases with extensive <em>Tinea corporis</em> infection, only 20% of cases were found to have normal levels of serum vitamin D3 whereas 48.3% of cases were found to have serum vitamin D3 insufficiency and 31.7% of cases had deficiency of serum vitamin D3</p><p><strong>Conclusions: </strong>Screening for vitamin D3 deficiency for all cases with extensive <em>Tinea corporis</em> infection can be recommended. Further large scale clinical trials are needed to assess whether vitamin D3 deficiency has any role to play in pathogenesis and treatment of extensive <em>Tinea corporis</em> infection.</p>

scholarly journals Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009–2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

EXPERIENCE OF EVALUATION OF PATIENTS OF OBSTRUCTIVE JAUNDICE BY SONOGRAPHY AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY AT A TERTIARY CARE CENTRE IN EASTERN INDIA

2021 ◽  
pp. 61-64
Author(s):  
Santosh Kumar Prasad ◽  
Nupur Nupur ◽  
Akshit Pathak ◽  
Indra Shekhar Thakur ◽  
Vijay Shankar Prasad
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Hepatic Duct ◽  
Tertiary Care ◽  
Pancreatic Head ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Stricture Formation ◽  
Tertiary Care Centre ◽  
Left Hepatic Duct ◽  
Cross Sectional

INTRODUCTION: Jaundice means yellow due to the yellowish discolouration of skin, sclera, and mucous membrane seen in jaundice caused by bilirubin pigment. It is divided in to two forms obstructive(surgical) and non- obstructive (non-surgical). AIM AND OBJECTIVE: To evaluate patients of obstructive jaundice by sonography and magnetic resonance cholangiopancreatography and compare the reporting and ndings by both the modalities. MATERIALS AND METHODS: Cross sectional observational study done from November 2018 to October 2020 and consists of 32 patients who had clinical jaundice and consented to being subjected to both ultrasound and MRCP. OBSERVATIONS:Both USG and MRCP were able to detect extrahepatic CBD dilatation equally in 25 patients. In 5(15.6%) patients USG and MRI both demonstrated intrahepatic mass causing obstruction at the level of conuence of right and left hepatic duct or CHD. Ultrasonography was able to detect the intrinsic mass of the extrahepatic common bile duct in 2(6.2%) patients out of 32 patients in our study population. MRCP could detect the same in 6(18.7%) patients. In our study narrowing of CBD with stricture formation and upstream dilatation of biliary tree was identied in 10(31.2%) patients on MRCP. Ultrasound could diagnose the same in one patient. Both USG and MRCP were able to detect pancreatic head mass as well as pseudocyst. CONCLUSION: The accuracy of MRCP was found to be comparable to that of ERCP for diagnosis of etiology for obstructive jaundice. MRCP allows better lesion characterization and assessment. However, the patchy availability of MR machines become the main achilles heel for the surgeons as well as the radiologists. Hence the valuable role of the omnipresent ultrasonography become immense.

scholarly journals A Cross-Sectional Comparison of Drinking Patterns, Alcohol Use and Related Medical Morbidities in a Secondary Versus Tertiary Setting

2015 ◽  
Vol 11 (2) ◽  
pp. 152-157
Author(s):  
A Risal ◽  
H Tharoor
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Tertiary Care ◽  
Alcohol Use Disorders ◽  
Care Utilization ◽  
Drinking Patterns ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Patterns Of Drinking ◽  
Level Hospital

Background Alcohol Dependence exists in different spectrums at different settings and associated with various medical morbidities, disability and health care utilization costs. Objectives To study the drinking patterns, alcohol use disorders and alcohol related medical morbidities in patients diagnosed with Alcohol Dependence Syndrome (ADS) and attending out / in-patient psychiatry services at secondary and tertiary care centre. Methods A cross-sectional comparative study was done among the patients diagnosed with ADS attending psychiatry services at District hospital, Udupi and Kasturba Hospital, Manipal. Serial sampling was done. Patients having any other psychiatric illnesses were excluded. The two groups were compared in relation to socio-demographic variables, drinking related variables, patterns of drinking and alcohol related medical morbidities identified. Results Significant differences in some socio-demographic parameters among the patients from the two different treatment centers were found with secondary level hospital (N=50) having more illiterate, laborers and below the poverty line population in comparison to the tertiary level hospital (N=75). Maximum frequency of gastro-intestinal morbidities was seen in both the hospital population, irrespective of the patterns of drinking. Conclusion Alcohol use disorders and alcohol related medical morbidities show some variations in their presentations in the different treatment centers. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12492 Kathmandu University Medical Journal Vol.11(2) 2013: 152-157

scholarly journals Clinical and Etiological Profile of Mycotic Keratitis from a Tertiary Care Centre in South India

2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Corneal Ulcers ◽  
Prompt Treatment

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis

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