scholarly journals A STUDY ON TREATMENT PATTERN AND OUTCOMES OF POISONING CASES IN A TERTIARY CARE AND GOVERNMENT DISTRICT HOSPITAL

2017 ◽  
Vol 9 (4) ◽  
pp. 193
Author(s):  
Pathan Amanulla Khan ◽  
Dileep Chary M. ◽  
M. Manoj Kumar ◽  
B.b. Sarah Nousheen
Keyword(s):  
District Hospital ◽  
Tertiary Care ◽  
General Medicine ◽  
Treatment Pattern ◽  
Research Centre ◽  
Morbidity Rate ◽  
Medical College ◽  
Organophosphorus Poisoning ◽  
Different Types ◽  
Government District

Objective: Poisoning is a major prevalent problem, with thousands of deaths occurring every year, mainly in developing countries. The present study sought to identify the treatment pattern and outcomes of poisoning cases admitted to Basaveshwara Medical College and Hospital and Research Centre (BMCH and RC) and Government District Hospital and to determine the type of poison cases.Methods: This is a prospective observational study aimed to analyse the poisoning cases admitted to general medicine departments and emergency departments of BMCH and RC and Government District Hospital, Chitradurga, Karnataka for a period of six months. Results: A total of 100 cases were enrolled in this study. 63% of the cases were identified from BMCH and RC, with the remainder being from Government Hospital. The study shows that 41% of the cases were 21-30 y old. 48% (n=48) were males and 52% (n=52) were females. Different types of poisoning cases were observed; organophosphorus poisoning (OP) taking the lead, followed by snake bite cases. The study denotes a mortality rate of 4% and morbidity rate of 96%. A majority of cases were reported in the second quarter of the year.Conclusion: It was concluded from the above findings that young age adults constituted a significant percentage of the subjects. It is essential, therefore, to propose policies that can terminate the free trade of poisonous pesticides and to create awareness and periodically counsel the vulnerable group of the population.

scholarly journals ANTIHYPERTENSIVE PHARMACOTHERAPY IN HYPERTENSIVE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL AND MEDICAL COLLEGE IN INDIA

2021 ◽  
pp. 30-36
Author(s):  
RANJODH JEET SINGH
Keyword(s):  
Heart Rate ◽  
Tertiary Care ◽  
General Medicine ◽  
Olmesartan Medoxomil ◽  
Joint National Committee ◽  
National Committee ◽  
Total Period ◽  
Medical College ◽  
Group B ◽  
Stage 1

Aim and Objectives: The aim of the study was to compare the efficacy of Atenolol and Olmesartan in Stage-1 hypertension (HTN), and the adverse effect profile of Atenolol and Olmesartan in Stage-1 HTN. Methods: A prospective, randomized, open, and parallel study was carried out in 100 patients attending the outpatient department of General Medicine Department MMIMSR, Mullana, Ambala, India with Stage -1 HTN according to joint national committee VII. The patients were randomly divided into two groups to receive Tab. Atenolol 50 mg od (Group A, n=50) and Tab. Olmesartan medoxomil 20 mg (Group B, n=50) od for a total period of 12 weeks with regular follow up every 2 weeks from the baseline. At each visit, blood pressure (BP), heart rate, and adverse effects were evaluated. Laboratory investigations were carried out at baseline and end of the study period. p<0.005 was considered statistically significant. Results: Atenolol and Olmesartan medoxomil both significantly reduce BP and heart rate (p<0.005). Olmesartan medoxomil is more efficacious in reducing BP. Conclusion: Olmesartan medoxomil is a better choice for Stage -1 HTN between the two drugs as it leads to a greater decrement in BP.

scholarly journals PRESCRIPTION PATTERN OF DIURETICS IN A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
P G Chithara ◽  
Dr. Yogananda R ◽  
Dr. Bharathi DR
Keyword(s):  
Drug Interaction ◽  
Tertiary Care ◽  
General Medicine ◽  
Oral Route ◽  
Prescribing Patterns ◽  
Research Centre ◽  
Intravenous Route ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Drug Drug Interaction

Diuretics are drugs that increase the rate of urine flow; clinically useful diuretics also increase the rate of excretion of Na+ (natriuresis) and an accompanying anion, usually Cl. Diuretics are a mainstay of therapy for a wide variety of diseases ranging from hypertension to the nephrotic syndrome. Objective: To study the prescribing patterns of diuretics in General Medicine and ICU. To assess the drug-drug interaction of diuretics. To study the route of administration of diureics. Materials and methods: A prospective observational study was conducted over a period of six months at general medicine and ICU department of Basaveshwara Medical College and Hospital and Research Centre, Chitradurga.a otal of 100 in-patients are included as study subject. Results: Mostly prescribed diuretic in this study were furosemide (52.9%), followed by mannitol (28.1%), spironolactone (11.57%), torsemide (5.79%), amiloride (0.82%) and hydrochlorothiazide (0.82%). Out of 100 prescriptions 84.4% of diuretics prescribed in intravenous route, 15.6% of diuretics prescribed in oral route. Out of 100 prescriptions total 89 drug interactions with diuretics are found. In that 2.3% major interactions and 67.4% moderate interactions and 30.3% minor interactions are found. Conclusion: Prescription monitoring helped to reduce the diuretic usage errors with respect to dose and drug-drug interaction with other prescribed drugs to provide better patient care. Keywords:  prescribing pattern, drug-drug intraction, diuretics

scholarly journals A retrospective observational study of poisoning and hanging cases during lockdown as a marker of emotional tide of COVID-19 pandemic in a tertiary care center in Northwestern India

2021 ◽  
Vol 8 (9) ◽  
pp. 1354
Author(s):  
Aradhana Singh ◽  
C. L. Nawal ◽  
H. L. Saini ◽  
Khusboo . ◽  
Abhishek Yadav ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Public Health Emergency ◽  
Behavioral Changes ◽  
Tertiary Care Center ◽  
Legal Cases ◽  
Medical College ◽  
Northwestern India ◽  
Organophosphorus Poisoning ◽  
The Impact

Background: In January 2020, WHO declared the outbreak of a new coronavirus disease COVID-19 to be a public health emergency of international concern. Worldwide lockdown led to panic, mass unemployment, poverty and domestic violence. The present study was designed to observe the impact of lockdown on the spectrum of medico-legal cases being admitted with drastic events of poisoning and hanging.Methods:In this retrospective, observational and comparative study, around 131 patients were recruited from the admitted patients in the medicine wards in SMS medical college and hospital during COVID-19 lockdown period from 23 March 2020 to 31 May 2020 after applying inclusion and exclusion criterias. Their clinical profile were noted and comparatively assessed with patients admitted in medicine wards during adjoining pre-lockdown period, that is, from 12 January 2020 to 22 March 2020.Results: Out of 131 cases recruited during lockdown period, hanging cases were 10 (8%) while it was 10 cases out of 213 (5% )during pre-lockdown period. Organophosphorus poisoning was 4.5% and 1.4%, celphos poisoning was 3.8% and 2.3%, rat killer poisoning was 3.05% and 1.4% during lockdown and pre-lockdown period respectively. Cases due to ingestion of other than the major group of poisoning were lower (3.8%) during lockdown period while it was 10.3% during pre-lockdown period.Conclusions:Extreme negative behavioral changes precipitated by corona and this might be aggravated further by complete lockdown, to which people resorted to the means which were easily available to them at home like hanging and common poisonings. 

scholarly journals A study of clinical profile of renal involvement in diabetic patients in correlation with diabetes complication at tertiary care center, Gujarat, India

2020 ◽  
Vol 7 (4) ◽  
pp. 630
Author(s):  
Virendra Kosamiya ◽  
Niyati Gosai
Keyword(s):  
Diabetic Patient ◽  
Microvascular Complications ◽  
Care Center ◽  
Renal Involvement ◽  
Tertiary Care ◽  
General Medicine ◽  
Diabetic Patients ◽  
Female Ratio ◽  
Medical College ◽  
Male Female Ratio

Background: The chronic complications of diabetes are broadly divided into microvascular and macrovascular, with the former having much higher prevalence than latter. Microvascular complications include neuropathy, nephropathy and retinopathy. Objectives of the study was to assess the clinical and biochemical profile of renal involvement in diabetic patient and complications due to diabetes mellites.Methods: This was a hospital based prospective study done in which total of 250 cases attended and admitted at general medicine department, Government Medical College, Sir. T. Hospital, Bhavnagar. Study included Diabetic patient having age - >12 years, Both Gender and Patient who gives consent for study.Results: Almost 54.8% having age between 41-60 years, Male: female ratio 0.87:1 and 44.0% were to ‘obese 2’ Body mass index (BMI) category. Around 22.4% participants have retinopathy, 30.0% have anemia, 62.4% have HTN and 26.8% have Ischemic Heart Disease (IHD). Almost 59.6% participants have S. creatinine level was 1.3 to 4 mg/dL and 43.6% have stage 5 of Chronic Kidney Disease (CKD).Conclusions: Incidence of DM Nephropathy increase with age. With increasing numbers of years of diagnosed DM, the chances of DM Nephropathy are increased and as the duration of DM as well as duration of uncontrolled glycemia increases GFR decreases and DM Nephropathy progresses. HbA1c is a useful marker to account for the glycemic control over the past months, and hence the better indicator to the development as well as progression of DM Nephropathy.

scholarly journals A study of clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center

2019 ◽  
Vol 6 (3) ◽  
pp. 574
Author(s):  
Rahul Gandhi G. ◽  
Taha Mahboob Ali Khalid
Keyword(s):  
Ct Scan ◽  
Care Center ◽  
Tertiary Care ◽  
General Medicine ◽  
Clonic Seizure ◽  
Clinical Profile ◽  
Medical College ◽  
Common Presentation ◽  
Common Etiology ◽  
The Brain

Background: Confusion lies over the diagnosis when the patients show ring enhancing lesions of the brain on CT scan. Some consider it as tuberculoma while some consider it as cysticercosis. More studies are required to give clear picture of ring enhancing lesions of the brain. The objective was to study clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center.Methods: This study was conducted in the Department of General Medicine, SVS Medical College, Mahabubnagar district which is a tertiary care referral hospital in the state of Telangana. This study was done during the period from July 2006 to October 2008. A total of 50 cases were taken up for this study. After selecting the patients for the study, already prepared protocol was followed strictly for each patient. The protocol contained identification data, detailed history and examination of central nervous system and peripheral signs for tuberculosis and cysticercosis.Results: The males were more than the females and 14-24 years age group was most affected. The most common presentation of ring enhancing lesions was seizures alone in 72% of the cases. Out of these cases the most common presentation was generalized tonic-clonic seizure in 40% of the cases. Majority i.e. 45 had single ring enhancing lesion on CT scan of the brain. The most common etiology of the ring enhancing lesion was found out to be neurocysticercosis in 54% of the cases of ring enhancing lesions.Conclusions: Ring enhancing lesions should be considered in differential diagnosis of those who present with seizures in endemic areas like India. 

scholarly journals Duration of Hospital Stay and Treatment Pattern among Patients Undergoing Common Operative Procedures at tertiary care hospital in Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 27-35
Author(s):  
Sanjay Chaudhary ◽  
Lokeshwar Chaurasia ◽  
Jitendra Kumar Singh
Keyword(s):  
Hospital Stay ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Treatment Pattern ◽  
Operative Procedures ◽  
Care Hospital ◽  
Third Generation ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Significant Difference

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.

Spontaneous Adverse Drug Reaction Monitoring in a Tertiary Care Centre

2020 ◽  
Vol 15 (3) ◽  
pp. 215-221
Author(s):  
Kirandeep Kaur ◽  
Preet Kanwal ◽  
Pardeep Goyal ◽  
Paramjit Singh ◽  
Sahil Yakhmi ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
General Medicine ◽  
Individual Case ◽  
Tertiary Care Centre ◽  
Adverse Drug Reaction Monitoring ◽  
Medical College ◽  
Spontaneous Adverse Drug Reaction ◽  
The Individual ◽  
Almost All

Background and Objective: Adverse drug reactions (ADRs) are associated with increased economic burden on the society. Monitoring of ADRs can help in decreasing the incidence of preventable adverse reactions. Methods: Under Pharmacovigilance Program of India, collection and reporting of ADRs has been going on at Dayanand Medical College and Hospital since January 2011. Here, we have analyzed the individual case safety reports (ICSRs) reported and uploaded between January 2017 and June 2019 from our centre. The ADR form provided by PvPI was used for collecting information, and the causality assessment was done according to the WHO-UMC scale. Results: A total of 498 ICSRs were uploaded through Vigiflow software during this period. Highest number of ADRs were recorded in the age group of 31-45 years (29.01%) and the least number of ADRs were recorded in the children less than 15 years of age (6.76%). General Medicine ward reported the highest number of ADRs and the antibiotics were most commonly associated with ADRs (26.21%), followed by antipsychotics (13.83%) and NSAIDs (12.14%). More than 90% of ADRs were non-serious (93.17%) and most of the ADRs were skin and soft tissue related (49.20%). Conclusion: Spontaneous reporting among indoor patients shows highest number of ADRs with use of antibiotics and almost all of the ADRs were non-serious in nature. Almost half of the total ADRs were skin and subcutaneous tissue related. Continuous efforts are required for further strengthening of the pharmacovigilance program of India.

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 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 Experience of Female Urogenital Fistula – a Shift of Dominance From Obstetric Variety to Iatrogenic One

2020 ◽  
Vol 21 (2) ◽  
pp. 71-75
Author(s):  
Md S Islam ◽  
Md Zaman Masud
Keyword(s):  
District Hospital ◽  
Birth Trauma ◽  
Vaginal Route ◽  
College Hospital ◽  
Medical College ◽  
Urogenital Fistula ◽  
Operative Complications ◽  
Different Types ◽  
Abdominal Route ◽  
Urogenital Fistulae

Aim: This retrospective study was carried out in Jessore Medical College Hospital and Jhenidah District Hospital on different types of female urogenital fistulae to evaluate its aetiological aspect in the present health care scenario of the country. Materials and Methods: Female patients presenting with features of urogenital fistula were evaluated properly and operated through intra-abdominal and vaginal route depending upon the merit of the fistula. Aetiological pattern of the cases was evaluated along with surgical outcome and post-operative complications. Result: Ofthe 28 female urogenital fistulas, 27 (96.43%) were VVF and 1(3.57%) was UVF. Out of 28 cases, 71.42 %( 20patients) were post-hysterectomy complication, 21.42 %( 6 patients) cases resulted from birth trauma and 7.14 %(n=2) cases were post caesarean complication. Trans-abdominal route was used for operation in 22 (78.56%) cases while 6 (21.42%) cases were operated through trans-vaginal route. In this series of 28 cases, 89.29 %( 25 cases) patients were fully cured and10.71 %( 3cases) patients experienced recurrence. Conclusion: The aetiological pattern of the female urogenital fistula in our country has changed substantially from the dominance of birth trauma to post hysterectomy indicating a remarkable improvement in maternal care system along with development of other socioeconomic parameters. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.71-75

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