scholarly journals Clinical Variables Responsible for Early and Late Diagnosis of Foreign Body Aspiration in Pediatrics Age Group

2020 ◽  
Author(s):  
Samarth Goyal ◽  
Shubhika Jain ◽  
Guruprasad Rai ◽  
Rajkamal Vishnu ◽  
Ganesh Sevagur Kamath ◽  
...  
Keyword(s):  
Foreign Body ◽  
Tertiary Care ◽  
Diagnostic Algorithm ◽  
Clinical Findings ◽  
Foreign Body Aspiration ◽  
Late Diagnosis ◽  
Medical Emergency ◽  
Care Hospital ◽  
Age Group ◽  
Main Complaint

Abstract Background: Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention, it can lead to collapse, consolidation and pneumonia of the affected lung. Methods: We retrospectively analyzed 37 pediatric case records who presented from January 2014-December 2018 with foreign body aspiration. Our primary aim was to assess the parameters responsible for early and late diagnosis of foreign body aspiration. We concluded with a diagnostic algorithm for management of foreign body aspiration on the basis of this outcome.Results: Around 32.5% came with a history of aspiration, 43% were referred from the primary centers with a suspicion for the same and the rest came to our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea. Furthermore, those who came in after a week had a dry cough and fever as their main complaint. Majority of ingested foreign bodies was a vegetative type (80%) as compared to the non –vegetative.Conclusion: Unlike adults, foreign body aspiration in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in the majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication.

scholarly journals Clinical Variables Responsible for Early and Late Diagnosis of Foreign Body Aspiration in Pediatrics age Group

2020 ◽  
Author(s):  
Samarth Goyal ◽  
Shubhika Jain ◽  
Guruprasad Rai ◽  
Rajkamal Vishnu ◽  
Ganesh Sevagur Kamath ◽  
...  
Keyword(s):  
Foreign Body ◽  
Tertiary Care ◽  
Diagnostic Algorithm ◽  
Clinical Findings ◽  
Foreign Body Aspiration ◽  
Late Diagnosis ◽  
Medical Emergency ◽  
Care Hospital ◽  
Age Group ◽  
Main Complaint

Abstract Background Incidence of foreign body aspiration ( FBA ) has been noticed maximally in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is of respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention it can lead to collapse, consolidation and pneumonia of the affected lung. Methods We retrospectively analysed 37 pediatric case records who presented from January 2014-December 2018 with FBA. Our primary aim was to assess the parameters responsible for early and late diagnosis of FBA. We concluded with a diagnostic algorithm for management of FBA on the basis of this outcomes. Results Around 32.5% came with a history of aspiration, 43% were referred from primary centers with a suspicion for the same and the rest came our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea where as those who came in after a week had dry cough and fever as their main complaint. Majority of ingested foreign body was vegetative type (80%) as compared to the non -vegetative material (20%). Conclusion Unlike adults, FBA in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication.

scholarly journals Clinical variables responsible for early and late diagnosis of foreign body aspiration in pediatrics age group

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Samarth Goyal ◽  
Shubhika Jain ◽  
Guruprasad Rai ◽  
Rajkamal Vishnu ◽  
Ganesh Sevagur Kamath ◽  
...  
Keyword(s):  
Foreign Body ◽  
Tertiary Care ◽  
Diagnostic Algorithm ◽  
Clinical Findings ◽  
Foreign Body Aspiration ◽  
Late Diagnosis ◽  
Medical Emergency ◽  
Care Hospital ◽  
Age Group ◽  
Main Complaint

Abstract Background Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention, it can lead to collapse, consolidation and pneumonia of the affected lung. Methods We retrospectively analyzed 37 pediatric case records who presented from January 2014–December 2018 with foreign body aspiration. Our primary aim was to assess the parameters responsible for early and late diagnosis of foreign body aspiration. We concluded with a diagnostic algorithm for management of foreign body aspiration on the basis of this outcome. Results Around 32.5% came with a history of aspiration, 43% were referred from the primary centers with a suspicion for the same and the rest came to our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea. Furthermore, those who came in after a week had a dry cough and fever as their main complaint. Majority of ingested foreign bodies was a vegetative type (80%) as compared to the non –vegetative. Conclusion Unlike adults, foreign body aspiration in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in the majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication.

scholarly journals Study of Drug Utilization on Acute Poisoning Cases Treated at Tertiary Care Hospital

2018 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Sreya Todi
Keyword(s):  
Drug Utilization ◽  
Urban Areas ◽  
Tertiary Care ◽  
Acute Poisoning ◽  
Medical Emergency ◽  
Poison Control ◽  
Care Hospital ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Cross Sectional

Acute poisoning is common everywhere in medical emergency.  Acute poisoning may be due to deliberate exposure to drugs, chemicals and natural toxins or accidental which is emergency for common medical health.  The main aim of this study was to investigate the pattern of drug utilization, poisoning agents, and outcome in patients with treated acute poisoning. Material and Methods:  This prospective cross sectional study was carried out in the emergency department of a tertiary care centre over a one year period. Result: During the period of 1 year total 310 Acute poisoning cases were recorded by us. Out of 310 acute poisoning cases 170(54.8%) were male where as females were 140(45.2%). The majority of cases were from age group of 20 -50 years in males whereas mean age of female patients was 37.3 years and majority of the cases were from 25-50 age group. The most common route of exposure to poisons (69.6%) was ingestion and followed by dermal exposure (in cases of venomous animal exposures) (25.8%) and inhalation (4.6%).The most common symptomatic treatments given to the patients were antimicrobials (88.7% of cases),  antiemetics (82.6%% of cases), H2 blockers (72.9% of cases) and Atropine (51% of cases), pralidoxime (41.6% of cases)  Proton pump inhibitors and  Vasopressor agents  etc respectively. The most commonly prescribed specific antidotes were Anti-snake venom (ASV) (12.9% of cases).Conclusion: In the present study, the main causes of poisoning were identified as household products in urban areas of India. Awareness about the dangers of such poisons should be the added responsibility of  health and hospital authorities. Poison control center establishment in the region will also help in preventing and controlling such poisoning events.

scholarly journals Epidemiology and Clinical Outcome of Snakebite in Western Nepal: A Retrospective Study

2019 ◽  
Vol 12 (1) ◽  
pp. 53-57
Author(s):  
D Karki ◽  
B Sharma ◽  
R Koirala ◽  
A Nagila
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Teaching Hospital ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Snake Bite ◽  
Medical Emergency ◽  
Care Hospital ◽  
Age Group ◽  
Snake Bites

Introduction: Snakebite is an environmental hazard associated with significant morbidity and mortality. It is an important medical emergency and cause of significant numbers of hospital admissions in many parts of the Asian region. In this study, we assess the epidemiology and clinical outcome of snake bite. Methods: This was a retrospective study of all patients with snake bites admitted to the Department of Internal Medicine, Manipal Teaching Hospital, Pokhara, kaski, Nepal. A total numbers of 265 snake bite cases in the period of 2013 to 2016 were enrolled in this study. Snake bite cases by person, place and time along with month of snake bite and time of bite, were analyzed. We also identified the types of snake and site of the bite. Sign and symptoms were clinically observed and the management of the snake bite cases was clinically done. Prothrombin time (PT) test along with INR value was performed by Medical Technologist at the Department of Laboratory, Manipal Teaching Hospital. Data was entered in to the Microsoft excel and analyzed by SPPS version 21.0. Percentages were applied to find the results. Results: Total numbers of snake bite cases were 265. More than half, 60.4% of the snake bite cases were females. Regarding the age group, nearly half, 47.9% were in the age group of 20 - 40 years and 9.8% cases were in the age group of 60 years and above. In this study, 50.6% bite cases were held at the day time and most of the bites were reported/ observed in the limb, 53.6% in lower limb, and 43.4% in the upper limb. Very few bites were in the head, neck and trunk. Our result shows 49.1% were green snake and 30.9% snake were unidentified. When we observed the sign and symptoms, 153 (57.7%) cases showed local swelling, 83 (31.3%) showed fang mark. Hematological manifestation were 144 (54.3%) cases and complication observed in 145 (54.7%) cases. Snake bite cases were managed after PT/INR test, INR. Antibiotic were prescribed in 154 cases and in 135 (50.9%) cases blood was transfused. There were no fetal cases noticed among hospital admitted snake bite cases. Conclusion: There is gross disparity in the management and outcomes of snake bite in different hospitals. Snake bite cases should manage in tertiary care hospital as early as possible.

scholarly journals Prevalence of Foreign Body Aspiration in Children in a Tertiary Care Hospital

2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Kripa Dongol ◽  
Yogesh Neupane ◽  
Heempali Das Dutta ◽  
Bigyan Raj Gyawali ◽  
Bijaya Kharel
Keyword(s):  
Foreign Body ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
University Teaching ◽  
Care Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity

Introduction: Foreign body aspiration is a common problem in children with signifi cant mortality and morbidity. This study aims to determine the prevalence of foreign body aspiration in children in a tertiary care hospital of Nepal. Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital from April 2010 to March 2016 after obtaining ethical approval from Institutional Review Committee (Reference number- 08(6-11)E277/78). All children of age up to 15 years with suspected foreign body aspiration were included. The data was collected from the medical record section and entered in Microsoft Excel. The descriptive statistical analysis was performed. Results: A total of 26,294 patients were included in the study. The prevalence of foreign body aspiration in children was found to be 98 (0.37%). On rigid bronchoscopy, 82 patients (83.6%) were confirmed to have a foreign body in the airway. The peak incidence of foreign body aspiration was seen in patients of age group one to two years. The commonest foreign body in the airway was a peanut. Conclusions: The prevalence of foreign body aspiration in children was low, which is similar to other studies. Foreign body aspiration may lead to dreadful complications. Therefore, both the clinicians and the public need to be cautious about it.

scholarly journals A retrospective analysis of acute poisoning cases admitted to a tertiary care hospital in South India

2019 ◽  
Vol 8 (10) ◽  
pp. 2271
Author(s):  
Nishanthi Anandabaskar ◽  
Reveda Murugan ◽  
Nitya Selvaraj ◽  
Mohanasundaram Jayaraman ◽  
Meher Ali Rajamohammad ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Acute Poisoning ◽  
Medical Emergency ◽  
Accidental Poisoning ◽  
Care Hospital ◽  
Age Group ◽  
Plant Seeds

Background: Acute poisoning is a medical emergency and a global public health problem. The poisoning pattern varies across countries and even between different regions within a country. The aim of this was to explore the demographic, etiological, and clinical characteristics of acute poisoning cases admitted to a tertiary care hospital in Puducherry, South India.Methods: This was a retrospective hospital record based study of acute poisoning cases admitted to our hospital during the period from January 2015 to December 2017. The patients’ demographic, etiological and clinical characteristics were analyzed.Results: Of the total of 275 cases of acute poisoning, majority of them were in the age group of 21- 30 years (32%) and were females (58.5%). Most of the cases were suicidal in nature (75.3%). Majority of the patients consumed a single poisonous agent (92.7%) and the route of poisoning was oral in all of them. Majority of the patients (56.7%) reached the hospital within 2 hours of exposure to the poison with median duration of hospital stay of 2 days, and mortality of 2.9%. Majority of the suicidal poisonings were associated with abuse of insecticides (39.4%), rodenticides (19.7%) and plant seeds (14.4%); whereas the accidental poisonings were mostly due to household agents (79.1%).Conclusions: Our study shows that the majority of the poisoning cases occurred with a single poisonous agent consumed orally, for suicidal purposes in young age group and women. Pesticides and plant seeds were commonly abused for committing suicides and household agents dominated the list of causes for accidental poisoning.

scholarly journals Diagnostic Errors in Initial Misdiagnosis of Foreign Body Aspiration in Children: A Retrospective Observational Study in a Tertiary Care Hospital in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Yingchao Zhu ◽  
Qijun Fan ◽  
Lijun Cheng ◽  
Bobei Chen
Keyword(s):  
Foreign Body ◽  
Test Performance ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
Diagnostic Testing ◽  
Diagnostic Errors ◽  
Foreign Body Aspiration ◽  
Care Hospital ◽  
Alternative Diagnosis ◽  
Primary Institutions

Background: Foreign body aspiration (FBA) in children is a common emergency that can easily be missed, leading to delays in treatment. Few large cohort studies have focused on errors in diagnostic assessment. The main purpose of this study was to analyze factors contributing to the initial misdiagnosis of FBA in children.Methods: We retrospectively reviewed the charts of 226 children diagnosed with FBA at the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from January 2018 to November 2020. Cases were divided into two groups according to whether or not patients were initially misdiagnosed. The clinical characteristics of the two groups were then compared. The Diagnosis Error Evaluation and Research (DEER) taxonomy tool was applied to cases with initial misdiagnosis.Results: Of the 226 included children with a final diagnosis of FBA, 153 (67.7%) were boys. Ninety percent of patients were under 3 years old. More than half (61.9%) of the children were referred from primary institutions, and 38.1% visited tertiary hospitals directly. A total of 80 (35.4%) patients were initially misdiagnosed. More than half of misdiagnosed children received an alternative diagnosis of bronchiolitis (51.3%), the most common alternative diagnosis. Test failures (i.e., errors in test ordering, test performance, and clinician processing) were primarily responsible for the majority of initial diagnostic errors (76.3%), followed by failure or delay in eliciting critical case history information (20.0%). Characteristics significantly associated with initial misdiagnosis were: presentation over 24 h (OR 9.2, 95% CI 4.8–17.5), being referred from primary institutions (OR 8.8, 4.1–19.0), no witnessed aspiration crisis (OR 7.8, 3.0–20.3), (4) atypical signs or symptoms (OR 3.2, 1.8–5.7), foreign body not visible on CT (OR 36.2, 2.1–636.8), foreign body located in secondary bronchi (OR 4.8, 1.3–17.2), organic foreign body (OR 6.2, 1.4–27.2), and history of recurrent respiratory infections (OR 2.7, 1.4–5.3). Children with misdiagnosis tended to have a longer time from symptom onset to the definitive diagnosis of FBA (P < 0.001).Conclusions: More than one-third of children with FBA were missed at first presentation. Errors in diagnostic testing and history taking were the main reasons leading to initial misdiagnosis.

scholarly journals Analysis of pesticide poisoning cases in a tertiary care hospital, Mumbai

2019 ◽  
Vol 1 (1) ◽  
pp. 12-14
Author(s):  
Rajesh D. Kharat ◽  
RAHUL VITTHAL KEDARE
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Care Hospital ◽  
Age Group ◽  
Pesticide Poisoning ◽  
Female Ratio ◽  
Safety Practices ◽  
Hindu Religion ◽  
Lower Socioeconomic

The pesticide poisoning is a common medical emergency and leads to morbidity and mortality in developing countries due to easy accessibility and less cost. A prospective analysis of pesticide poisoning cases admitted to the emergency department of tertiary care, teaching hospital, Mumbai, Maharashtra from 1st January 2006 to 31st December 2006. The main objectives, to assess the pattern and socio-demographic profile of pesticide poisoning. The most cases observed in the age group 21-30 years (n:72, 41.37%)). Total males affected were 94 (54.02%) dominating the females 80 (45.98%) and male to female ratio (1.17:1). But in younger age group, females were more affected than males. The maximum cases belonged to the lower socioeconomic class (n:82, 47.12%) and urban areas (n:106, 60.91%). Majority of the victims married and belonged to Hindu religion (n: 140, 80.4%). The occurrence of pesticide poisoning was more frequent in the evening (n:82,47.12%) and during the, monsoon (73, 41.95%).There is a need for adequate guidelines for sale, use, storage and safety practices for the pesticide. These will be helpful for the enhancement of the knowledge, awareness and safety practices among the population for prevention and reduction of the pesticide poisoning. It also emphasized on the early availability of treatment in the poisoning cases.

Prescribing trends of antidiabetic drugs in diabetic and hypertensive diabetic patients in an urban tertiary care hospital of Bangladesh

2017 ◽  
Vol 3 (3) ◽  
pp. 338-343
Author(s):  
Mohammad Didar Khan ◽  
Md. Ibrahim ◽  
Md. Mizanur Rahman Moghal ◽  
Dipti debnath ◽  
Asma Kabir ◽  
...  
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Microsoft Excel ◽  
Patient Profile ◽  
Prescribing Trends ◽  
Medical University ◽  
Insight Into

Objective: The present epidemiological study was conducted with the objectives of providing an insight into the current use of antidiabetic medications to diabetics and hypertensive diabetics in urban areas and determining how the patient factors influence the prescribing of antidiabetic medications. Methodology: Data of patients of past two years were collected from Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. The details were entered in the structured patient profile form. Data were statistically analyzed using the Microsoft Excel 2007 software. Result: A total of 958 patient’s data were collected and analyzed of which 632 (65.97 %) were males and 326 (34.03 %) were females. These patients were further categorized based on their age. 330 patients (34.45 %) belonged to the age group 20 – 44 years, 504 (52.61 %) to the age group 45 – 65 years and 124 (12.94 %) to the age group 65 – 80 years. 684 (71.4%) patients out of the 958 patients studied were suffering from coexisting hypertension. Co-existing hypertension was found to be more prevalent in the age group 45 – 65 years (67.69%) and was found more in females (84.04%). Conclusion: Metformin was the oral hypoglycemic which was the highest prescribed. In hypertensive diabetics Metformin and Pioglitazone were most frequently prescribed drugs. Biguanides and Insulin were the most commonly prescribed antidiabetics. A combination of two or more drugs of different classes was prescribed to hypertensive diabetics. It is necessary to have an improved understanding of the etiology and pathophysiology of diabetes to focus on research efforts appropriately.

A Study on prescribing pattern of drugs in orthopaedic in-patient department at a tertiary care hospital in Guntur region

2020 ◽  
Vol 8 (2) ◽  
pp. 60-70
Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Delivery ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Prescribing Pattern ◽  
Prescribing Indicators ◽  
Bed Days

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.

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