scholarly journals Awareness and Community Response To Stroke Signs and Symptoms Following the National ‘Act Fast’ Campaign in An Ethnically Diverse Population

2021 ◽  
Author(s):  
Zain A. Bhutta ◽  
Sameer A. Pathan ◽  
Tuukka Puolakka ◽  
Naveed Akhtar ◽  
Stephen H. Thomas ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Signs And Symptoms ◽  
Community Response ◽  
Stroke Onset ◽  
Care Hospital ◽  
Stroke Patients ◽  
Convenience Sample ◽  
Total N ◽  
Female Ratio ◽  
Study Population

Abstract Background Evaluation of public education stroke campaigns and behavioral studies to assess emergency response at stroke onset are scarce. We aimed to assess patient’s and bystanders’ foreknowledge of stroke signs and symptoms and their response at stroke onset. We also enquired if ‘Act FAST’ stroke campaign in Qatar contributed to their foreknowledge. Methods In Qatar, the first national stroke awareness campaign, ‘Act FAST’, was launched in May 2015. The study population included a convenience sample of stroke patients admitted to the stroke service in Qatar’s largest tertiary care hospital from November 2015-February 2016. We interviewed patients with acute onset stroke admitted to the stroke unit using a validated questionnaire. If the patient had disabling stroke, we interviewed relatives/bystanders present at stroke onset. The primary outcome was the correct response of calling Emergency Medical Services (EMS), recognizing the possibility of stroke. Results The questionnaire was administered to 165 participants, 142 (86.1%) stroke patients, and 23 (13.9%) bystanders. The mean age of the study population was 52.6 (SD = 11.7), and sex (male-female) ratio was 7:1. Ethnic categories were South-Asian (n = 101, 62.2%), Middle-Eastern (n = 14, 8.5%), Far-Eastern (n = 26, 15.8%), African (n = 16, 9.7%) and Others (n = 8, 4.9%). From the study group, 33 (20.1%) participants had foreknowledge of stroke signs and symptoms, and of these, 27 (16.5%) knew about the Act FAST campaign in Qatar. The behavioral responses of the participants (total n = 165) on stroke onset included; immediately activated EMS (n = 55, 33.3%), called friends/relatives (n = 69, 41.8%), drove to hospital (n = 33, 20%), decided to rest and waited for improvement in condition (n = 21, 12.7%), and 12 (7.3%) responded as none of the above. Of the participants who admitted having watched the Act FAST campaign, 92.6% (25/27) reported that the campaign affected their response to stroke onset. There was no association of ethnicity, marital status or FAST campaign awareness with behavioral response of EMS activation on stroke onset. Conclusions The foreknowledge of stroke signs and symptoms and the Act FAST campaign was low in the community. However, seeking help by activating EMS at stroke onset was generally high in the study population irrespective of the awareness to the campaign.

scholarly journals Prevalence of Modifiable Risk Factors among Stroke Patients in a Tertiary Care Hospital in Dhaka

1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
History Of ◽  
Arachnoid Hemorrhage

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21

scholarly journals Incidence of scrub typhus in a tertiary care hospital in Kolkata, India

2020 ◽  
Vol 7 (5) ◽  
pp. 825
Author(s):  
Kausik Munsi ◽  
Sayonee Das ◽  
Ramiz Islam ◽  
Parvez Shahide Biswas ◽  
Satyabrata Ganguly ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Signs And Symptoms ◽  
Care Hospital ◽  
Female Ratio ◽  
Gi Symptoms ◽  
Ns1 Antigen ◽  
Morbilliform Rash ◽  
Almost All

Background: Authors aimed to identify incidence of scrub typhus among patients of fever. Scrub typhus is an endemic disease in India caused by Orientia tsutsugamushi, transmitted by trombiculid mites. It is an important cause of acute febrile illness in India. Signs and symptoms include fever, headache, myalgia and GI symptoms and is generally associated with morbilliform rash (<40%), eschar (<50%) which is due to bite of the mite. Abnormal LFTs and lymphocytosis are commonly seen in early phase of illness. It’s often labelled as PUO. Early diagnosis and prompt administration of therapy mostly leads to complete recoveryMethods: Authors screened 100 patients presenting with fever, malaise, headache, with or without rash for more than a week from the month of May to December 2019. Routine blood investigations with fever profile (Dengue NS1 antigen, MP, MPDA, TyphidotM) and cultures were done. Patients in whom no cause of fever could be established, having lymphocytosis, hyponatremia and transaminitis, they were tested for Scrub typhus by using Indirect immunofluorescence & detection of IgM antibody.Results: Total 22 patients were found positive for scrub typhus by using the aforementioned method (22%). Male: Female ratio was 3:4 (9 vs 12). Patients were in the age group of 16-76 years. Lymphocytosis, hyponatremia and transaminitis were cardinal features seen in almost all patients diagnosed with Scrub Typhus.Conclusions: This study will help clinicians to have a stronger suspicion of scrub typhus in undiagnosed febrile patients.

scholarly journals Study On Stroke In Young Patient Due To Cardiac Disease in Tertiary Care Hospital in Dhaka City

2016 ◽  
Vol 17 (2) ◽  
pp. 95-99
Author(s):  
Sanjoy Kumar Saha ◽  
Prodip Kumar Biswas ◽  
Meherunessa Mukta ◽  
Mohammed Shahadat Hossain ◽  
Mimal Kumar Basu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
Valvular Heart Diseases

Objectives: Study of the risk factors associated with stoke due to cardiac disease in age group between 18 to 45 years of age,evaluate the risk factor of hospitalized stroke patients & to search for cardiac disease associated with stroke also appropriate preventive measure applicable for our country.Materials & Methods: Non randomized prospective observational study was carried out in the department of Neurology, Medicine & Cardiology unit of Dhaka Medical College Hospital between the periods of July 2009 to December 2009. Fifty (50) consecutive indoor patients more than 18 years of both sex admitted with suspicion of stroke. Diagnosis of stroke will be made from details clinical history clinical examination and confirmed by CT scan or MRI.Result: Fifty patients were randomly chosen for this study, of which 26 (52%) patients were male, 24 (48%) patients were female & male: female ratio was 1.08:1. Highest incidence of stroke was in between 3rd & 4th decade. The incidence of ischemic stroke 46 (92%) & hemorrhagic stroke 4(8%).Cardio embolism is the major (92%) risk factor for ischemic stroke. Among the cardiac risk factors, valvular disease (64%), MI (16%), &IHD (10%), Atrial fibrillation 8%, Patent foramen ovale 2%.Among the patients 33.33% of women with cerebral infarction were using OCP. Majority of the patients in this study were sedentary worker (45%). Among the stroke patients 8% & 10% had previous H/O stroke & TIA respectively.Conclusion: In this study a number of modifiable risk factors were identified, of which valvular heart disease & HTN are important risk factor next are DM & IHD smoking. Most of the valvular heart diseases are rheumatic in origin, which can be prevented through primary & secondary prevention of rheumatic fever.J MEDICINE July 2016; 17 (2) : 95-99

A STUDY ON CLINICAL PROFILE AND OUTCOME OF SNAKE ENVENOMATION IN CHILDREN AT TERTIARY CARE HOSPITAL JHALAWAR, RAJASTHAN

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Abhishek Bansal ◽  
Kalu Ram Meena
Keyword(s):  
Tertiary Care ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Pediatric Intensive Care ◽  
Signs And Symptoms ◽  
Snake Bite ◽  
Lower Limbs ◽  
Common Symptom ◽  
Care Hospital ◽  
Female Ratio

Background: Snake bite is generally considered to be a rural problem and has been linked with environmental and occupational condition is a neglected public health problem. Method: This study was conducted in children admitted with snake bite in Pediatric Intensive Care Unit in the year 2019. Their demographic details, site of bite, arrival time, 20Minutes Whole Blood Clotting time, clinical signs and symptoms, complications and outcome were measured. Results: The male: female ratio was 1.33:1. Peak age group affected was 6 to 12 years old children. Lower limbs were commonly bitten. 88.1% of children arrived in the hospital between 0 and 6 hours after the bite. Pain and swelling at the site of bite were the most common symptom of envenomation. There were only two deaths during the study period. Conclusion: Snake bite is a life threatening emergency. Identification, timely diagnosis and early administration of anti-snake venom will certainly aid to curb mortality in snake bite.

scholarly journals Epidemiological, clinical profile and outcome of multi-system inflammatory syndrome in children (MIS-C) admitted in government tertiary care hospital of Kanyakumari district

2021 ◽  
Vol 8 (11) ◽  
pp. 1879
Author(s):  
Steeve Gnana Samuel ◽  
Suresh Placode Monikanta ◽  
Arul Prasath Subramoniam Vasudevan ◽  
Nagalekshmi Rajamanickam
Keyword(s):  
Tertiary Care ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Intensive Care Treatment ◽  
Care Hospital ◽  
Cutaneous Manifestations ◽  
Female Ratio ◽  
Wide Range ◽  
High Index Of Suspicion ◽  
Inflammatory Syndrome

We report twelve children with a median age of 7 year (IQR 3years to 12 years) who fulfilled MIS-C WHO criteria. The male to female ratio was 2:1. Affected children had gastrointestinal symptoms (92%), respiratory symptoms (67%), cardiovascular symptoms (58%), neurological symptoms (50%), renal symptoms (33%), followed by muco-cutaneous manifestations (25%). 83% of children had lymphocytopenia. It was found that lymphocytopenia was directly correlated to disease severity. The majority of the children had elevated CRP, transaminase, and deranged coagulation profiles. All 4 systems were involved in 7 children (58%). Intensive care treatment was required for all the cases (100%). There were no deaths. Children with coronavirus disease 2019 (COVID-19) associated MIS-C can present with a wide range of signs and symptoms. They can deteriorate quickly and hence a high index of suspicion; early referral and early initiation of treatment with steroids and IVIg can save the lives of children with MIS-C.

scholarly journals Patient Profiles of Pott’s Diseases: Experience of 50 Cases in a Tertiary Care Hospital in Dhaka City

2017 ◽  
Vol 2 (2) ◽  
pp. 48-50
Author(s):  
Md Shafiul Alam ◽  
Amir Mohammad Khan ◽  
Tayseer Farzana ◽  
Md Abdus Salam ◽  
Abdur Rabban Talukder
Keyword(s):  
Spinal Tuberculosis ◽  
Tertiary Care ◽  
Health Sector ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College ◽  
Study Population

Background: Spinal tuberculosis is a great problem in the health sector. Objective: The purpose of the present study was to see the see the socio-demographic characteristics of spinal tuberculosis patients. Methodology: This study was designed as descriptive cross sectional study which was carried out in the Department of Neurosurgery at Dhaka Medical College Hospital during the period of January 2002 to December 2004 for a period of two (2) years. All the patients who were presented with spinal tuberculosis at any age with both sexes were included as study population. The details of socio-economic condition were recorded of all the patients. Confirmation of spinal tuberculosis was made by CT-scan and MRI. Finally biopsy was done to confirm the cases by histopathology.Results: In this study, 50 cases of tuberculosis of the spine patients were recruited for this study. The mean age with SD was 25.4±18.65 years. The sex distribution shows male preponderance with a male and female ratio of 1.63:1. Regarding the socioeconomic status 33 (66%) patients came from low class society. In this study majority of the study population were illiterate which was 19(38.0%) cases. Most of the patients were day labourer which was 17(34.0%) cases.Conclusion: In conclusion young adult male patients are most commonly affected by spinal tuberculosis.Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 48-50

scholarly journals Clinical study of perforations among patients at a tertiary care hospital

2018 ◽  
Vol 5 (9) ◽  
pp. 3078
Author(s):  
Mahesh S. V. ◽  
Dilip Kumar Reddy ◽  
Hota P. K.
Keyword(s):  
Tertiary Care ◽  
Time Lapse ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Age Group ◽  
Female Ratio ◽  
Abdominal Organs ◽  
Male Preponderance ◽  
Study Population ◽  
Diagnostic Modalities

Background: Non-traumatic gastrointestinal perforations have received far less attention in the recent medical literature than inflammations, tumoral or traumatic lesions of solid abdominal organs. The objective is to study perforations among patients at a tertiary care hospital.Methods: Patients diagnosed as non-traumatic perforations of the internal organs as diagnosed by authors were planned to be included for the present study. Diagnosis was based on history, clinical examination, and required investigations. All such patients were included in the present study that was enrolled for the present study during the study period. Such 50 patients could be studied. Non-traumatic perforation with regard to age, sex, causes, clinical presentation, diagnostic modalities required was evaluated.Results: Most common age group involved is in 3rd to 4th decade in the present study. Male preponderance (82%) was seen; with a male to female ratio was 4.6:1. The time lapse between onset of symptoms and presentation at the hospital was more than 24 hours in 24% of the study population. Abdominal pain was the most consistent symptom and was seen in 100% of the study population in the present study followed by vomiting (52%) and fever (46%). Distended abdomen was seen in 46% of study population in the present study. Tenderness was seen in all the cases and is more prominent at the site of perforation. Guarding/rigidity and absent bowel sounds were seen in 92% of the study population. Sensitivity of imaging in detecting gas under diaphragm was 72% by USG abdomen and 80% by plain radiography.Conclusions: Risk factors for increased morbidity and mortality in the present study include older age group, delayed presentation and features of shock.

scholarly journals Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

2021 ◽  
Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

scholarly journals Nasogastric Tube Feeding Practice and Associated Complication in stroke Patients in a Tertiary Care Hospital in Bangladesh

2018 ◽  
Vol 4 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Kazi Mohibur Rahman ◽  
Sharif Uddin Khan ◽  
ATM Hasibul Hasan ◽  
Sirajee Shafiqul Islam ◽  
Rajib Nayan Chowdhury ◽  
...  
Keyword(s):  
Aspiration Pneumonia ◽  
Nasogastric Tube ◽  
Tertiary Care ◽  
Tube Feeding ◽  
Electrolyte Imbalance ◽  
Feeding Practice ◽  
Care Hospital ◽  
Stroke Patients ◽  
Nasal Irritation ◽  
Nasogastric Tube Feeding

Background: Nasogastric tube feeding is an integral part of management of stroke patients with feeding difficulties.Objectives: The purpose of the present study was to evaluate the nasogastric tube feeding practice and its complication on stroke patients.Methodology: One hundred (100) adult patients aged ≥ 18 years with stroke were enrolled in the study. The diagnosis of stroke was established by the clinical presentation, neuroimaging. Patients requiring nasogastric tube feeding was included in the study. They were thoroughly examined for any complications from possible use of nasogastric tube. Their caregivers were also thoroughly interviewed using a standard preformed questionnaire regarding any complications as well. Results: A total number of 100 patients were recruited for this study. In this study population, 63.0% patients had ischaemic stroke; 26.0% had haemorrhagic stroke and 9.0% population had sub-arachnoid haemorrhage. The most common indication for NG feeding was difficulty in swallowing (39.0%) followed by semi consciousness (26.0%), unconsciousness (22.0%), inability to maintain feed (10.0%). About 71.0% of the patients had complications from NG tube feeding such as nasal irritation (53.0%), electrolyte imbalance (43.0%), aspiration pneumonia (40.0%) and diarrhea (38.0%).Conclusion: Nasal irritation, aspiration pneumonia, electrolyte imbalance, diarrhea are common complications associated with NG tube feeding which in part may be related to faulty feeding technique.Journal of National Institute of Neurosciences Bangladesh, 2018;4(1): 23-27

COMPARISON OF CLINICO-SOCIAL PROFILE OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL IN A RURALAREA: A RETROSPECTIVE STUDY

2021 ◽  
pp. 70-72
Author(s):  
Gaurav Santosh Nemade ◽  
Sumit Nitin Dhus ◽  
Arushi Ramesh Shetty ◽  
Neha Dhananjay Firake
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary Tuberculosis ◽  
Younger Age ◽  
Tobacco Addiction ◽  
History Of ◽  
Early Case ◽  
Male To Female ◽  
Clinical Characteristic

BACKGROUND AND OBJECTIVES: The burden of tuberculosis (TB) in India is the highest accounting for 26% of the global incidence. A total of 1.4 million people died from TB in 2019 (including 208 000 people with HIV). India accounts for a fourth of the global burden of TB and 29% of global mortality. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristic between pulmonary TB (PTB) and extrapulmonary TB (EPTB). MATERIALS AND METHODOLOGY:Aretrospective analysis was carried of 348 patients diagnosed in DOTS centre, Pravara Rural Hospital, Loni. Characteristics of demographic and clinical characteristics were obtained from medical case records. RESULTS:Among the 348 cases, 71.3% were PTB and 28.7% were EPTB including, pleural (36%), meningeal (27%) and lymphatic (20%) cases. The male to female ratio in PTB and EPTB are 1.99 and 1.22 respectively. EPTB was more common at younger age (<25 years). Tobacco addiction (10.9%), diabetes mellitus (4.03%), HIV positivity (12.1%) and history of contact with Tb patients (17.7%) were more likely to be associated with PTB. CONCLUSION:Increased awareness of the risk factors may facilitate early case nding and better management outcomes for these patients.

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