Evaluation of Pattern of Use of Prescribed Oral Hypoglycaemic Drugs in Newly Diagnosed Diabetic Nephropathy Patients Visiting a Tertiary Care Hospital of Southern Bihar

2020 ◽  
Vol 7 (43) ◽  
pp. 2492-2496
Author(s):  
Rajan Goyal ◽  
Himanshu Jindal ◽  
Abhilasha Singh ◽  
Abhishek Kamendu
Keyword(s):  
Renal Function ◽  
Diabetic Nephropathy ◽  
Tertiary Care ◽  
General Medicine ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Oral Hypoglycaemic Agents ◽  
Total Study Population ◽  
Medical College ◽  
Oral Hypoglycaemic Drugs

BACKGROUND Diabetes is the most important risk factor for chronic kidney disease. Because of this, clearance of many oral hypoglycaemic drugs from our body is hampered and time of exposure to these drugs increases. Therefore, patients of diabetes need to be assessed frequently for the development of diabetic nephropathy and the dosage of oral hypoglycaemic drugs should also be modified accordingly. So, the purpose of this study was to evaluate the doses of prescribed OHAs in newly diagnosed diabetic nephropathy patients. METHODS A hospital based observational study was conducted at Narayan Medical College and Hospital, Sasaram, Bihar, India. A total of 600 diagnosed patients of diabetic nephropathy of age more than 18 years visiting for the 1 st time in OPD of general medicine / nephrology department were included in the study after obtaining an informed consent. The results were expressed as a percentage of the assessed population. RESULTS Only about 38% of the total study population was taking doses of Oral Hypoglycaemic Agents (OHAs) according to their GFR status. 62% were taking wrong doses of OHAs with their respective renal function. CONCLUSIONS Treatment of diabetes in a CKD patient is more difficult than in non-CKD patient. GFR status should be monitored on regular basis in patients of diabetes with CKD. A significant number of these patients are still treated with wrong dosage of OHAs for their respective renal function. KEYWORDS Wrong Dose of OHA, Diabetic Nephropathy, Oral Hypoglycaemic Drugs

scholarly journals Clinico-epidemiological study of facial hyper-melanoses among patients attending dermatology outpatient department at a tertiary care hospital at Pondicherry

2019 ◽  
Vol 6 (1) ◽  
pp. 48
Author(s):  
Chitralekhya Rao ◽  
Oudeacoumar Paqurissamy ◽  
Govardhan J. ◽  
Varsha Medasani
Keyword(s):  
Epidemiological Study ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Care Hospital ◽  
Age Group ◽  
Total Study Population ◽  
Medical College ◽  
Pigmentary Disorders ◽  
The Face ◽  
Study Population

<p class="abstract"><strong>Background:</strong> Hypermelanoses involving predominantly the face and the neck is relatively common and often presents a complex diagnostic problem. The present study titled “Clinico-epidemiological study of facial hyperpigmentation” was done in the study population of 500 patients of facial pigmentation, attending the skin outpatient department in AarupadaiVeedu Medical College and Hospital from October 2015 to September 2017.</p><p class="abstract"><strong>Methods:</strong> Aim and objective of the study was to study various clinical patterns of facial pigmentation, their clinical characteristics, their association with other pigmentary disorders and to evaluate the different etiotogical and precipitating factors. A special proforma was prepared. Patients were thoroughly interviewed and examined to find out dermatological and systemic diseases and they were subjected to investigations to evaluate different etiological factors and diagnose the clinical type of facial pigmentation.<strong></strong></p><p class="abstract"><strong>Results:</strong> The present study showed a strong female preponderance. Among the total study population there were 55% cases of melasma, 20% cases of Riehls melanosis, 10% cases of periorbital pigmentation and 5% of miscellaneous causes.</p><p><strong>Conclusions:</strong> Facial pigmentation was commonly seen in the females. 21-30 years age group was the most commonly affected age group in all types of facial pigmentation. Melasma, Riehls melanosis and periorbital pigmentation were the most common clinical types of facial pigmentation observed.</p>

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 Utilization of fresh frozen plasma in a tertiary care hospital in central Kerala

2021 ◽  
Vol 9 (5) ◽  
pp. 1374
Author(s):  
S. N. Sreelekshmi ◽  
Lekshmidevi . ◽  
G. Rajan ◽  
M. S. Suma
Keyword(s):  
Care Setting ◽  
Tertiary Care ◽  
General Medicine ◽  
Fresh Frozen Plasma ◽  
Care Hospital ◽  
Microsoft Excel ◽  
Case Record ◽  
Medical College ◽  
Fresh Frozen ◽  
Frozen Plasma

Background: The demand for blood and its components always exceeds the supply in our health care setting. Hence there is a need to prioritize the usage of these components. An audit makes this possible. The present study is conducted on utilization of Fresh frozen plasma which is one of the most requested blood components.Methods: The study was conducted on the first 241 FFP transfusions during the study period of 1 year. Requisition forms for issuing FFP from various departments were reviewed and relevant data collected. Patients’ case record was also retrieved to collect data related to the transfusion episodes. The data collected were compiled, coded and expressed using descriptive statistical tools like mean, mode, percentage and ratio using Microsoft Excel 2010.Results: Most of the patients who underwent FFP transfusion were males and in the age group 60-70. Most of the requests for FFP issue came from Cardiothoracic department. Most common indication for FFP transfusion was raised PT INR. FFP units remained unutilized in CTVS, General surgery and general medicine. 20% of the received request forms were incompletely filled with the Clinical diagnosis and Indication for FFP being most frequently omitted information.Conclusions: Various departments at Government Medical College, Kottayam are efficiently utilizing FFP. But more intervention is needed in addressing issues related to the sending of requisition forms and ensuring adequate usage of FFP to prevent its wastage.

scholarly journals Prevalence, Clinical Profile and Outcome of Patients Presenting with Stroke

2021 ◽  
pp. 146-157
Author(s):  
N. Akshaya Thrinetrapriya ◽  
M. Jagadeesan
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
General Medicine ◽  
Lifestyle Changes ◽  
Care Hospital ◽  
Stroke Patients ◽  
Eligibility Criteria ◽  
Medical College ◽  
Awareness Campaigns ◽  
Scale Scores

BACKGROUND: Stroke is a clinical condition that has a greatly increasing prevalence in the recent years owing to our ‘modern’ sedentary lifestyle. The aim of this study is to assess the prevalence, risk factors, clinical presentation and outcome of patients presenting with stroke in a tertiary care hospital. METHODOLOGY: A prospective observational study was conducted in the Department of General Medicine, Saveetha Medical College & Hospital, Thandalam, Chennai for a period of 4 months, i.e., from January 2021 to April 2021.Stroke patients who met the eligibility criteria were included in the study. All sociodemographic and clinical data were recorded by reviewing the patient and his medical records regularly. Scores like NIHSS (National Institute of Health Stroke Scale) score and mRS (modified Rankin scale) scores were calculated and TOAST categorisation was done. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) software. RESULTS: Out of 100 stroke patients, 65% were males and 35% were females. Mean age was 57.95 years. Ischemic strokes were seen in 85% of patients and the rest 15% had hemorrhagic stroke. The most common presentation was facial palsy (67%), followed by hemiparesis (62%) and hemiplegia (38%). The important risk factors were hypertension (70%), diabetes mellitus (48%) and obesity (42%). Based on mRS scores, 59% of the patients had bad outcome. CONCLUSION: Hypertension and diabetes were the most common risk factor in our study population. Preventive measures include creating awareness, lifestyle changes and compliance to medications. National programmes on stroke prevention initiate and coordinate awareness campaigns to reduce the incidence, morbidity and mortality of stroke. Finally, a multidimensional approach involving the patient community, general population, medical fraternity and government authorities is essential to curtail this modern epidemic.

RELATIONSHIP OF HYPONATREMIAAMONG PATIENTS ADMITTED IN ICU OF A TERTIARY CARE HOSPITAL IN WEST BENGAL

2021 ◽  
pp. 1-3
Author(s):  
Partha Pratim Dey ◽  
Debarshi Jana
Keyword(s):  
West Bengal ◽  
Tertiary Care ◽  
Hypovolemic Shock ◽  
General Medicine ◽  
Care Hospital ◽  
Serious Adverse Event ◽  
Medical College ◽  
One Year ◽  
Relationship Of ◽  
Paediatric Critical Care

Introduction: Hyponatremia is a serious adverse event in the paediatric critical care population is especially complex as many patients require multiple continuous infusion and excess uid volumes due to hypovolemic shock or blood pressure instability. Aim & objective:To detect hyponatremia among patients admitted in medical icu of agmc & gbph and to study its etiology. Objectives 1. To nd out the proportion of patients admitted in icu having hyponatremia. 2. To study the etiology of hyponatremia in these patients. Material & methods: One year starting from 1st Nov 2019 to 31st October 2020. All the patient admitted in the ICU; age more than 18 years, size was depend on the total admission within the study period in General Medicine, Murshidabad Medical college and R. G. Kar Medical college, West Bengal. Conclusion: We found that most common age group 41-60. It was found that male were predominance than female. It was found that 96(27.9%) patients had Hyponatremia We found that 22(6.4%) patients had Euvolemia, 49(14.2%) patients had Hypervolemia, 25(7.3%) patients had Hypovolemia and 248(72.1%) patients had normal.

SEROPREVALENCE OF HIV AND HBsAg AMONGST BLOOD DONORS IN A TERTIARY CARE HOSPITAL, CHHATTISGARH.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Anusha P ◽  
Bankar Nandkishor J ◽  
Karan Jain ◽  
Ramdas Brahmane ◽  
Dhrubha Hari Chandi
Keyword(s):  
Hepatitis B ◽  
Blood Donors ◽  
Hepatitis B Surface Antigen ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Blood Bank ◽  
Care Hospital ◽  
Medical College ◽  
The World ◽  
First Time

INTRODUCTION: India being the second highly populated nation in the world. HIV/AIDS has acquired pandemic proportion in the world. Estimate by WHO for current infection rate in Asia. India has the third largest HIV epidemic in the world. HIV prevalence in the age group 15-49 yrs was an estimate of 0.2%. India has been classified as an intermediate in the Hepatitis B Virus (HBV) endemic (HBsAg carriage 2-7%) zone with the second largest global pool of chronic HBV infections. Safety assessment of the blood supply, the quality of screening measures and the risk of transfusion transmitted infectious diseases (TTIs) in any country can be estimated by scrutinizing the files of blood donors. After the introduction of the blood banks and improved storage facilities, it became more extensively used. Blood is one of the major sources of TTIs like hepatitis B, hepatitis C, HIV, syphilis, and many other blood borne diseases. Disclosure of these threats brought a dramatic change in attitude of physicians and patients about blood transfusion. The objective of this study is to determine the seroprevalence of transfusion transmitted infections amidst voluntary blood donors at a rural tertiary healthcare teaching hospital in Chhattisgarh. MATERIAL AND METHODS: This retrospective study was carried out in Chandulal Chandrakar Memorial Medical College, Kachandur, Durg. Blood donors were volunteers, or and commercial donors who donated the blood and paid by patients, their families, or friends to replace blood used or expected to be used for patients from the blood bank of the hospital. After proper donation of blood routine screening of blood was carried out according to standard protocol. Laboratory diagnosis of HIV 1 and HIV 2 was carried out by ELISA test. Hepatitis B surface antigen was screened by using ELISA. RESULTS: A total of 1915 consecutive blood donors’ sera were screened at Chandulal Chandrakar Memorial Medical College, blood bank during study period. Of these 1914 were male and 1 female. The mean age of patients was found to be 29.34 years with standard deviation (SD) of 11.65 Years. Among all blood donors in present study, 759(39.63%) were first time donors and 1156(60.37%) were repeated donors. 1 patient was HIV positive in first donation group while 3 (75%) were positive in repeat donation group. 7 (38.9%) were HBsAg positive in in first donation group while 11(61.1%) were positive in repeat donation group. Two patients in first donation group had dual infection of HIV and HBsAg. CONCLUSION: Seropositivity was high in repeated donors as compared to first time donors. The incidence of HIV is observed to be 0.2% and that of HBsAg is 0.94%. Strict selection of blood donors should be done to avoid transfusion-transmissible infections during the window period.

HISTOPATHOLOGICAL EVALUATION OF WHO CLASSIFIED MULTIBACILLARY LEPROSY CASES IN A TERTIARY CARE CENTRE, SOUTH KERALA

2021 ◽  
pp. 32-34
Author(s):  
Anita Sanker ◽  
G Nandakumar ◽  
Swapna Balkrishnan
Keyword(s):  
Immune Response ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Newly Diagnosed ◽  
Epithelioid Cells ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Leprosy Patients ◽  
Epidermal Atrophy ◽  
Multibacillary Leprosy

There are signicant differences in the histopathology of leprosy lesions which is inuenced by the host immune response to Mycobacterium leprae. Objective - To nd the histopathological changes in newly diagnosed multibacillary leprosy(MB) cases registered in the skin department Government Medical College, Thiruvananthapuram. Method- skin biopsy performed in 40 multibacillary leprosy cases and histopathological ndings were evaluated. 70% showed epidermal atrophy. Granulomas, composed of sheets of foamy macro Results- phages, lymphocytes and epithelioid cells, were seen in 21 cases & twenty two cases were AFB positive. Eight cases each were lepromatous, borderline tuberculoid, mid boderline, borderline lepromatous types. Conclusion- Presence of 60% cases of borderline leprosy indicates the unstable immune response in leprosy patients. Majority were either borderline lepromatous or lepromatous showing the infective nature of multibacillary leprosy. Histopathological examination with Fite- Foroco staining is a crucial method and the gold standard for accurate diagnosis and typing of leprosy.

A STUDY OF THE MORPHOLOGY OF PLACENTA IN TERTIARY CARE HOSPITAL OF CENTRAL KARNATAKA, INDIA

2021 ◽  
pp. 51-53
Author(s):  
Saryu Sain ◽  
Tupakula Sharmila ◽  
Uttam Kumar ◽  
Anita Anita
Keyword(s):  
Tap Water ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Careful Examination ◽  
Minimum Length ◽  
Care Hospital ◽  
Dispersal Pattern ◽  
Medical College ◽  
Foetal Membranes ◽  
Morphology And Morphometry

Introduction: Placenta is a temporary structure, developed during Pregnancy and discarded at Parturition. Human Placenta is of Discoid and Haemo-Chorial type. It connects the foetus with the mother's womb. It is formed by the contribution of two Individuals - both Mother and Baby. At 1 term four- fth of Placenta is of foetal origin and one- fth is of maternal. Along with Amnion, Chorion, Allantois and Yolk sac, Placenta can also be considered as one of the foetal membranes, which acts as Nutritive and Protective to the developing Embryo. Method: - The present study was done on morphology and morphometry of 150 placentae carried at the Department of Anatomy, Basaveshwara Medical College & Hospital (BMCH), Chitradurga. The placentae were collected with prior ethical clearance and proper consent. Soon after the delivery the placental surface was washed thoroughly under running tap water which were then weighed, tagged and brought to the department of Anatomy, BMCH. The parameters like size, shape and attachment of umbilical cord were noted down. Gross examination was carried out according to the proforma. Result: - The maximum number of placentae belong to the range of 501-600 gms (38.7%). Least placental weight is recorded as 205 gms, showing dispersal pattern. The maximum recorded weight is 835 gms and the average being 491.4 gms. The majority of the placentae are discoid (63.3%). The minimum length recorded is 8.9 cms, maximum as 23.80 cms and the average being 18.3 cms. Conclusion: - Careful examination of Placenta can help in explaining adverse outcomes, their management in subsequent pregnancies and assessment of new born risk.

SOCIODEMOGRAPHIC AND ANTHROPOMETRIC PROFILE OF DIABETIC PATIENTS ATTENDING IN A DIABETIC CLINIC IN A TERTIARY MEDICAL COLLEGE AND HOSPITAL, WEST BENGAL

2021 ◽  
pp. 12-15
Author(s):  
Smarajit Banik ◽  
Sandip Saha ◽  
Sudipan Mitra ◽  
Ujjwal Pattanayak ◽  
Rajib Sikder ◽  
...  
Keyword(s):  
West Bengal ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Diabetes Clinic ◽  
Cross Sectional ◽  
Medical College ◽  
Study Participants

Background: Diabetes mellitus is one of the important causes of morbidity and mortality. With a rise in non communicable diseases in India, diabetes has become a modern epidemic showing a rising trend in West Bengal also. A large number of diabetes patients come to the diabetes clinic of our tertiary care hospital in North Bengal Medical College and Hospital, Darjeeling, West Bengal. The large proportion of patients presenting with this condition prompted us to study the Sociodemographic and Anthropometric Prole of such patients. Methods: This was a descriptive hospital based cross sectional study involving a total of 344 diabetic patients enrolled in the diabetes clinic of a tertiary care teaching hospital from December 2019 to February 2020. A self-administered questionnaire was used to collect data and was analyzed in Microsoft excel sheet and using SPSS 20.0 software. Results: Among the 344 study participants, we found that 220 (63.95%) were males and 124 (36.05%) were females. Diabetes was more common among those aged 51-60 years 108 (31.40%). Family history was present among 188 (54.65%) of the diabetic patients. Almost 160 (46.51%) patients have diabetes 1.1 – 5 years. Hypertension was present among 216 (62.79%) patients. Almost 218 (63.37%) of the patients were overweight and 84 (24.42%) were obese. Conclusions: The diabetic patients presenting to this tertiary care hospital belong lower socioeconomic strata and having limited education in their age group. There is high proportion of obesity and hypertension among them.

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