scholarly journals Psychiatric Illnesses among the Patients Admitted for Self-poisoning in a Tertiary Care Hospital of Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ajay Risal ◽  
Pushpa Prasad Sharma ◽  
Rajkumar Karki

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630

2019 ◽  
Vol 6 (3) ◽  
pp. 916
Author(s):  
Prashant R. Shinde ◽  
Meghraj J. Chawada ◽  
Sudhir B. Deshmukh

Background: In hemorrhoids, the anal canal venous plexuses become engorged. It can lead to bleeding, thrombosis, prolapse, pain. Study of surgical profile helps to educate the patients to take proper precautions to avoid the severe forms of it. The objective of the study was to study the surgical profile of patients with hemorrhoids at a tertiary care hospital.Methods: Present study was hospital based cross sectional study. It was carried out at a tertiary care hospital in the department of general surgery among 100 patients who presented with symptoms suggestive of hemorrhoids during the study period from 1st January 2017 to 31st October 2018.Results: Majority of the patients 41% were in the age group of 35-45 years. The number affected by hemorrhoids was more in males i.e. 56%. Incidence of hemorrhoids was more in upper class. Incidence of hemorrhoids was less i.e. 21% among those who took only vegetarian diet. Majority of the patients (78%) presented after one year of occurrence of treatment. 54% of the patients had third grade of hemorrhoids. Bleeding was present in the majority i.e. 98% of the patients. On anorectal examination, it was found that 44% of the patients had fissure and 23% of the patients had peri anal skin tag. Anorectal examination was within normal limits in 33% of the cases.Conclusions: Vegetarian diet may be protective against hemorrhoids. Bleeding was the most common presenting symptom. Thus, study helped to identify that being male, younger age group, non-veg diet may be the risk factors for hemorrhoids.


2020 ◽  
Vol 7 (4) ◽  
pp. 694
Author(s):  
Patirla Devendra Reddy ◽  
Pranavendra Nath Seela ◽  
Pravin Gulab Rao Maske

Background: Objective of the study was to determine the prevalence of Isolated B12deficient dementia in patients presenting to a tertiary care hospital. The MMSE was much lower in B12 deficiency compared to irreversible causes Thus, shorter duration, severe dementia, focal neurological signs, and a vegetarian diet were significantly associated with the development of B12 deficiency.Methods: Based on exclusion and inclusion criteria 100 patients were included in this study, a detailed history of the patient were taken with respect to duration of dementia and its symptoms, type and treatment. Study in terms of the correlation of the clinical features with investigations and diet. Estimation of the prevalence of dementia with reference to B12 deficiency. Mean MMSE analysis, assessment of the improvement in MMSE after treatment with B12 injections after a6-8 wks period.Results: In this study most of our patients were in the 60-69 age groups across all causes of dementia, 22out of 26, B12 deficient patients were vegetarians. This value was in keeping with the known fact that a vegetarian diet predisposes a person to develop B12 deficiency. The association between B12 deficiency, high MCV and megaloblastic blood picture in peripheral blood smear was significant. The MMSE scores were significantly lower 13.42 in patients with B12 deficiency as compared to those with Alzheimer's 14.3 means and those with multi-infarct state 17.3 means.Conclusions: The duration of the presentation in B12 deficiency was10-12months averagely. There was a significant improvement in MMSE after treatment in pureB12 deficient patients (by 9 points) if they presented within one year of symptoms. Except for myelopathy, there was an improvement in other neurological symptoms and signs. Early diagnosis and proper treatment can make improvements in a patient's memory and quality of life.


Author(s):  
Edakkattil Rameshkumar ◽  
Salini Ajitha

<p class="abstract"><strong>Background:</strong> Otitis externa, an inflammatory condition commonly reported in almost all age groups. But the prevalence and etiology are varying on different region. This study was aimed to find out the prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> All the patients presented with otitis externa in the outpatient department of ENT were included in the retrospective study. The history of self probing was identified using a questionnaire. The clinical presentation was noticed and organism was isolated from the swab taken from the external ear canal. The non-parametric data was expressed in numbers and percentage.  </p><p class="abstract"><strong>Results:</strong> Total 49 patients were included in the study. The average age of patient was 39.5±14.3 years with 24 males and remaining females. Among them, 85.7% (42/49) had a history of self probing (p&lt;0.05). The most prevalent age group for the self probing associated otitis externa was 31 to 40 years. The discharge was the major clinical presentation (40/49) and the common organism isolated was <em>Pseudomonas aeruginosa</em> in 38% of incidence.</p><p><strong>Conclusions:</strong> Self probing was major etiological factor for otitis externa in the age group of 31-40 years. Discharge was the major clinical presentation and the common organism isolated was <em>Pseudomonas aeruginosa</em>. This emphasized the need for a proper awareness programme in the society against self probing to reduce the incidence.</p>


Author(s):  
Chembetei Kavitha Kiran ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti

Background: Vulvovaginitis is one among the major pathologies encountered in reproductive age group. Etiologies are always multiple and candidiasis, bacterial vaginitis and trichomoniasis account for 90% of etiology. The incidence is dependable upon multiple factors like age group, ethnicity, socioeconomic status, geographical locale. Improperly treated and untreated vulvovaginitis is associated with long term complications like infertility, pelvic inflammatory disease in nulliparous females and preterm labour, miscarriage, ectopic pregnancy, chorioamnionitis among pregnant females and recurrent UTIs, cervicitis, endometritis, increased risk of acquiring STIs among normal females. The present study was undertaken with the objective of understanding the etiologies associated with vulvovaginitis among women attending Obstetrics clinic of a tertiary care hospital. The risk factors associated with the conditions, the features of the vaginal discharge and symptoms associated with each etiology were studied.Methods: A cross sectional study for a period of one year was conducted among 200 female patients attending the Department of gynecology for vaginitis and evaluated for etiology. Patient’s risk factors, clinical history, symptoms were collected by questionnaire and specimens were collected from all the cases and processed as per standard guidelines. Bacterial vaginosis was confirmed based on Neugent’s criteria, Trichomoniasis by wet mount examination and candidiasis by culture. The study was approved by the institutional ethical committee.Results: 137 cases of vulvovaginitis were diagnosed based on etiology. Vulvovaginitis was most common among 27-36 years and in multiparous women. Most common causative agent was Candida (59.12%) followed by bacterial vaginosis (22.63%) and Trichomoniasis (18.25%). Vaginal discharge was the commonest symptom (100%) followed by malodor and vulval irritation. Following unhygienic practices was the commonest risk factor associated with Vulvovaginitis.Conclusions: A regular evaluation is mandatory for all the females attending hospital for vaginitis. Successful management reduces the morbid conditions and it’s essential to treat the conditions during the pregnancy which prevents the complications associated like preterm birth, miscarriage etc. and adverse outcomes.


2021 ◽  
Vol 8 (14) ◽  
pp. 899-903
Author(s):  
Syed Ali Nasar Waris ◽  
Rubina Huda

BACKGROUND Congenital ocular anomalies are one of the important causes of childhood blindness. Blindness is a serious public health issue, and also a social and economic problem worldwide. Majority of global blindness is avoidable and curable. Most of global blindness is in developing countries. The objectives of this study were to determine the prevalence of congenital ocular anomalies in the paediatric age group and its associated risk factors in a tertiary care hospital in Kancheepuram. METHODS This cross-sectional study was conducted among children of 0 – 14 years age group attending the ophthalmology department of SRM Medical College and Hospital, Kancheepuram from December 2018 to November 2020. Congenital ocular anomalies were detected by detailed ocular examination and the type of congenital ocular anomaly was assessed. Associated risk factors like family history of congenital ocular anomalies, family history of consanguinity and significant antenatal history of the mother of the children were collected. RESULTS Out of 9865 cases, we found that 61 cases had congenital ocular anomalies. There was a male preponderance. Majority of the cases were in the age group 0 - 5 years. A positive history of consanguinity was present in 10 % of cases. The most commonly found cases were congenital cataract and congenital dacryocystitis. CONCLUSIONS Children with congenital ocular anomalies and functional vision should be given glasses and low vision aid. There is a great need for early screening, detection and treatment by paediatric or trained ophthalmologists in referral hospitals. KEYWORDS Congenital Ocular Anomalies, Paediatric Age Group, Prevalence


Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  

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.


2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.


Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Farzana Latif ◽  
Sadia Ilyas ◽  
Saeed Mehmood ◽  
Hammad Arif ◽  
Nuzhat Parveen Khawaja ◽  
...  

Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus. Key Words: Uterine artery embolization, Emergency peripartum hysterectomy, maternal morbidity and mortality, healthcare providers How to Cite: Latif F, Ilyas S, Mehmood S. Arif H. Khawaja P. Nuzhat. Jawad Z. J Clinical audit of obstetrical hysterectomies for a period of one year in a tertiary care hospital. Esculapio.2020;16(04):50-53.


2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.


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