scholarly journals Gender differences in awareness of diabetes mellitus among the rural population

2017 ◽  
Vol 8 (2) ◽  
pp. 44-49
Author(s):  
Iyshwarya Udaya Kumar ◽  
Jaya Prakash Murthy ◽  
Ujwal Upadya ◽  
Mahesh Venkatesh
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Public Awareness ◽  
Care Center ◽  
Tertiary Care ◽  
Education Programme ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Males And Females

Background: Diabetes Mellitus is a chronic disorder, which is becoming rapidly epidemic in India.There are many complications occur due to uncontrolled diabetes mellitus.The outcome of diabetes depends mainly on the patient’s self-management like health-related behavior, which is based on his or her knowledge. Awareness on diabetes mellitus is still a lacunae among the Indian population.Aims and Objective: To determine the knowledge regarding awareness of diabetes like the risk factors, symptoms, complications and the management among the males and females in rural population.Materials and Methods: It is a cross sectional study conducted at the tertiary care center in rural Bangalore. A structured questionnaire was used and 300 adults were assessed on their knowledge regarding the awareness of diabetes.Result: Out of 300 adults, 159 adults (53%) had a history of diabetes. There was no gender difference observed regarding the awareness, nor the education played a role. There was significant difference observed in knowledge of diabetes Mellitus among the diabetics with respect to renal complications (p <0.013), symptoms like blurring of vision (p < 0.043) and burning feet (p < 0.009).Conclusion: Both the diabetic and non-diabetic groups had very low awareness regarding diabetes and associated risk factors. Both Males and females awareness levels were poor. Proper Diabetic education programme will help in raising public awareness of the disease.Asian Journal of Medical Sciences Vol.8(2) 2017 44-49

scholarly journals Study of Delirium on Psychiatric Referrals at Helping Hands Community Hospital, Kathmandu, Nepal

2018 ◽  
Vol 5 (2) ◽  
pp. 19-26
Author(s):  
Praveen Bhattarai ◽  
Devavrat Joshi
Keyword(s):  
Risk Factors ◽  
Alcohol Intoxication ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Liaison Psychiatry ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
Associated Risk Factors

Background and Objectives: Delirium is one of the most important neuro-psychiatric disorders in Consultation liaison psychiatry. There is a dearth of studies in this subject in Nepalese context. The objective of this study was to find out the demographic profile, source of referral, reason for referral and possible risk factors for delirium and association between risk factors and subtypes of delirium.Material and Methods: This is a descriptive cross-sectional study carried out in a tertiary care center over a period of six months. Delirium was diagnosed by psychiatrist based on International Classification of Disease, 10th revision, Diagnostic Criteria for Research (ICD-10 DCR) and was classified into subtypes using the Liptzin and Levkoff criteria. Data analysis was done using SPSS version 16 and chi- square test was applied to find the association between risk factors and subtypes of delirium.Results: A total of 52 cases of delirium were included in the study. Majority of cases were aged 65 years and above with male preponderance. The most common cause for referral was disturbed behavior and disorientation. Hyperactive delirium was the most common subtype of delirium. Most of the referred cases of delirium were from Medical ward and Intensive Care Unit/Critical Care Unit (ICU/CCU). Infection / Inflammation, Drug/alcohol intoxication or withdrawal and those with multiple etiologies were the most common possible causes of delirium. There was no significant difference in terms of associated risk factors between the clinical subtype (p = 0.8023).Conclusion: The presence of delirium warrants prompt intervention to identify and treat the underlying causes and consultation liaison psychiatric services should be enhanced to achieve this goal.Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 19-26

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

scholarly journals Usefulness of the Non-Contact Tonometry in Out-Patient Screening

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose
Keyword(s):  
Central Corneal Thickness ◽  
Care Center ◽  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Significant Difference ◽  
Iop Measurement ◽  
The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 

scholarly journals Prevalence and Economic Significance of Hydatidosis on Cattle Slaughtered at Nekemte Municipal Abattoir, Western Ethiopia

2020 ◽  
Vol 5 (3) ◽  
pp. 57-63
Author(s):  
Tuge Temesgen ◽  
Keyword(s):  
Risk Factors ◽  
Public Awareness ◽  
Cattle Breed ◽  
Cross Sectional Study ◽  
Hydatid Cysts ◽  
Financial Loss ◽  
Cross Sectional ◽  
Viability Test ◽  
Significant Difference ◽  
And Control

Aim The study was conducted to determine the prevalence of hydatidosis, to identify the association between expected risk factors and occurrence of the disease, to investigate economic importance and to evaluate fertility and viability of the hydatid cyst in cattle slaughtered at the abattoir. Materials and Methods A cross-sectional study, which involves both ante-mortem and post-mortem examination, was conducted at Nekemte municipal abattoir from November 2015 to March 2016. Results A total of 355 local cattle breed was randomly sampled and examined for the presence of hydatid cysts in the organs of the animals using the standard meat inspection procedures, 66 (18.6%) animals were found harboring hydatid cysts. Statistical analysis showed that there was a significant difference (p<0.05) between the prevalence of bovine hydatidosis in all risk factors with exception of sex of the animals. Among 207 hydatid cysts recorded, 93 (44.92%) were from lungs, 65 (31.40%) from livers, 4 (1.93%) from heart, 3 (1.44%) from kidney, 1 (0.48%) from spleen and 41 (19.8%) were in two organs from lung and liver. Fifty-seven (57) of these 207 cysts were randomly selected and subjected to fertility and viability test which revealed 19 (33.33%) as fertile, 25 (43.86 %) sterile and 13 (22.81%) calcified. Viability test proved 7 (12.28%) of 19 fertile cysts as viable and 12 (21.05%) of 19 fertile cysts as non-viable. Viability of cysts in different organs revealed that 5 (16.1%) and 2 (10%) of cysts from lungs and liver, respectively. The estimated financial loss during the study period both due to condemnation of organs and an in direct carcass weight loss from hydatidosis was 2,190,143.52 ETB. Conclusion The results of this study revealed that bovine hydatidosis was an economically important disease of cattle which need serious attention for prevention and control actions in and around Nekemte. Hence, establishment of well-equipped standardized abattoirs, prohibition of backyard slaughter, creation of public awareness, deworming and control of stray dogs are of paramount importance.

Ischemic Stroke Subtypes: Socio-demographic Factors, Risk Factors, and Outcomes in Southern Sri Lanka

2021 ◽  
Vol 31 (4) ◽  
pp. 509-518
Author(s):  
Sathyajith Buddhika Ambawatte ◽  
Dulmini Nadeesha Weerathunga ◽  
Athula Dissanayake ◽  
Surangi Chandhi Somaratne ◽  
Kanishka Athukorala ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Sri Lanka ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Analysis ◽  
Cross Sectional Study ◽  
Stroke Subtype ◽  
Anterior Circulation ◽  
Cross Sectional

Background: Stroke is a heterogeneous, catastrophic disease. A comprehensive clinical analysis of ischemic stroke (IS) risk factors and outcomes is crucial for optimum management in resource-poor settings.Methods: A prospective cross-sectional study of acute cerebrovascular disease (ACVD) involving 592 patients was con­ducted in a tertiary care center in Sri Lanka from November 2018 to May 2019. We aimed to describe the ACVD subtypes and the relationship of IS subtypes and subtype-categories (as defined by the Oxfordshire Community Stroke Project clinical clas­sification) with risk factors, severity, and outcome.Results: The majority (63.3%) had IS. Partial anterior circulation syndromes (PACS), total anterior circulation syndrome (TACS), posterior circulation syndromes (POCS), and lacunar syndromes (LACS) accounted for 102 (29.7%), 58 (16.9%), 88 (25.7%) and 95 (27.7%) of the cases, respectively. The most common PACS sub-category was higher-cerebral-dysfunction-with-homonymous-hemianopia (HCD+HH,39 cases;38.2%). Cerebellar-signs-without-long-tract-signs (CS-LTS) sub-category constituted the highest among POCS (47 cases; 53.4%). The leading sub-category within LACS was pure-motor (PM) strokes (43 cases; 45.3%).Patients aged ≥50 years (adjusted-OR [AOR]2.439; 95%CI,1.163-5.116;P=.018), IHD(AOR 2.520; 95%CI,1.347-4.713; P=.004) and BMI>23kg/m2(AOR 2.607; 95% CI,1.420-4.784; P=.002) were 2.5 times more likely to associate with TACS. Patients with a history of TIA (AOR 1.910; 95%CI,1.036-3.524; P=.038) and arrhyth­mias (AOR 5.933; 95%CI,3.294-10.684; P<.001) were 1.9 and 5.9 times more likely to be associated with POCS respectively. Those with hypertension were 2.3 times more likely to associate with LACS (AOR 2.233; 95%CI,1.270-3.926; P=.005).NIHSS(P<.001), mRS on admission (P=.001) and in 3 months (P<.001), deaths during hospital stay (P=.003) and within 28 days (P<.001) had a stronger relationship with individual stroke subtypes.Conclusion: The comparative risk of different IS subtypes depends on differ­ent risk factors. The findings of this study demonstrate that sub-categories within each stroke subtype may behave independently with regard to risk factors and outcomes, thus warranting the need for individual assessment. Ethn Dis. 2021;31(4):509-518; doi:10.18865/ed.31.4.509

FEMALES HAVE EARLIER DISEASE ONSET THAN MALES AMONG HLA-CW6 POSITIVE PSORIASIS PATIENTS

2021 ◽  
pp. 1-2
Author(s):  
Akhilesh Behra
Keyword(s):  
Age Of Onset ◽  
Care Center ◽  
Tertiary Care ◽  
Disease Onset ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Male And Female ◽  
Female Patients ◽  
Males And Females

Background- Psoriasis is a chronic inammatory relapsing skin disorder. Environmental and genetic factors play an important role in the development of disease. HLA-Cw6 most strongly associated with disease. There is also a difference in HLA-Cw6 positivity in respect to gender, which affect occurrence of disease in males and females. Aims & Objectives- This study was aimed to determine the association of HLA-Cw6 positive and negative psoriasis individuals had any signicant differences in respect to disease onset among male and female Materials & Methods- An Institute based Cross sectional study was done in a tertiary care center in eastern India. All patients attending skin OPD were included in the study. Detailed history and blood samples were collected from patients. HLA-Cw6 typing has done by sequence-specic PCR method. Results- HLA-Cw6 positive female patients had a signicantly early age of onset than male patients (p value-0.009334) (20.88 vs. 27.91yr), while HLA-Cw6 negative patients did not show any signicant difference of age of onset between male and female ( p value- 0.406905) Conclusion- Although men are more commonly affected than female, HLA-Cw6 positive psoriasis female patients show earlier disease onset. This results show that genetic variations in terms of HLA-Cw6 are reected in the age of onset among males and females.

scholarly journals Anxiety among Doctors during COVID-19 Pandemic in Secondary and Tertiary Care Hospitals

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Syed Riazul Hasan ◽  
Zeeshan Hamid ◽  
Muhammad Talha Jawaid ◽  
Rashida Kaizar Ali
Keyword(s):  
Risk Factors ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Creative Commons ◽  
Significant Difference ◽  
Scale Scores ◽  
Associated Risk Factors ◽  
Tertiary Care Hospitals

Objective: To assess the level of anxiety among doctors during COVID-19 pandemic and the associated risk factors. Methods: This cross-sectional study was conducted from 30th April to 16th May, 2020 in Karachi, Pakistan. The data was collected via an online web-based questionnaire. Questionnaire was used to assess anxiety level using GAD-7 scale among health-care professionals and the risk factors playing role in it. Results: One hundred and fifty-one doctors participated in our study. Out of these 151 participants, 69 (45.7%) had mild, 22 (14.6%) had moderate, and 5 (3.3%) had severe symptoms of anxiety, whereas the remaining 55 (36.4%) had no anxiety according to GAD-7 scale. The median [interquartile range (IQR)] GAD-7 scale scores are 6.0 [3.00-9.00]. Females showed more severe degrees of measurement of anxiety symptoms than males. Doctors dealing with COVID-19 patients showed higher level of anxiety as compared to the doctors who were not dealing with COVID-19 patients, having a significant difference (U = 9.697, p = 0.008). One hundred and forty-one (93.4%) participants were concerned about being exposed to COVID-19 at work and 112 (74.2 %) thought they have inadequate protective equipment for safety. Conclusions: During COVID-19 pandemic, doctors exhibited different grades of anxiety. In order for healthcare workers to perform to the best of their capability, certain guidelines and interventions are needed. doi: https://doi.org/10.12669/pjms.36.6.3113 How to cite this:Hasan SR, Hamid Z, Jawaid MT, Ali RK. Anxiety among Doctors during COVID-19 Pandemic in Secondary and Tertiary Care Hospitals. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.3113 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Overweight is more prevalent in patients with Parkinson's disease

2012 ◽  
Vol 70 (11) ◽  
pp. 843-846 ◽  
Author(s):  
Hugo Morales-Briceño ◽  
Amin Cervantes-Arriaga ◽  
Mayela Rodríguez-Violante ◽  
Juan Calleja-Castillo ◽  
Teresa Corona
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Sectional Study ◽  
Normal Range ◽  
Cross Sectional ◽  
Significant Difference

Underweight and malnutrition are well documented in Parkinson's disease (PD), while overweight has been less reported. We carried out a cross-sectional study including 177 healthy controls and 177 PD patients attending a tertiary care center. We recorded weight and height for all participants. A statistically significant difference was found in body mass index (BMI) between controls and PD patients (29.1±5.4 versus 27.2±4.7, p<0.001). In the PD Group, two patients were underweight, 32.7% were within normal range, 46.9% had overweight, and 19.2% were obese. Overweight and normal weight were more prevalent in the PD Group (p=<0.01 and <0.001, respectively) when compared to controls. In conclusion, overweight/obesity are common among patients with PD, while underweight is almost negligible.

scholarly journals Prevalence-pattern and risk factors of Cesarean section in a multiethnic cohort

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Khadija Murtaza ◽  
Madeeha Chaudhry ◽  
Shabana Nazeer ◽  
Sajid Malik
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Birth Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Obstetric Complications ◽  
Cross Sectional ◽  
Multiethnic Cohort

Objective: This study was aimed to elucidate the prevalence-pattern and determinant of cesarean section (CS) in a multiethnic cohort from Pakistan. Methods: Through a cross-sectional study design, women delivering at a tertiary care center were recruited during 2013-2017. Data on socio-demographic variables, obstetric complications and birth outcome were obtained. Descriptive statistics, bivariate and multivariate logistic regression analyses were performed. Results: A total of 5,275 pregnant women were recruited and 43% of the deliveries underwent CS. Odds of CS were significantly higher in subjects originating from Azad JammuKashmir and Sindh regions, speaking Potohari and Pahari languages, women in advance ages, and those who were housewives. CS had significantly lower odds of prenatal mortality but increased odds of postnatal mortality. Obstetric factors that appeared to be significant predictors of CS were multiparity, breech position, fetal distress, oligohydroamniosis, preeclampsia, and previous scar. Conclusion: This study revealed high variability in CS in various socio-demographic strata of study population. The obstetric complications highlighted in this study may be reduced by proper perinatal counseling and pregnancy monitoring and should be the focus of intervention programs as suggested in the Millennium Development Goals. doi: https://doi.org/10.12669/pjms.37.3.3186 How to cite this:Murtaza K, Chaudhry M, Nazeer S, Malik S. Prevalence-pattern and risk factors of Cesarean section in a multiethnic cohort. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3186 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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