scholarly journals Clinical Profile of Patients Admitted with Seizure Disorder in a Tertiary Care Hospital of Central Nepal

2021 ◽  
Vol 17 (2) ◽  
pp. 129-135
Author(s):  
Isha Bhandari ◽  
Kalpana Karmacharya Malla ◽  
Pukar Ghimire ◽  
Bibek Bhandari
Keyword(s):  
Tract Infection ◽  
Febrile Seizure ◽  
Tertiary Care ◽  
Age Groups ◽  
Birth Asphyxia ◽  
Neurological Deficits ◽  
Care Hospital ◽  
Age Group ◽  
Upper Respiratory Tract ◽  
History Of

Introduction:  Seizure is one of the common presentation and reason for  hospital admission in children. This study aims to address the etiology and clinical characteristics of the patient. Methods: This was a descriptive, cross-sectional study in which children of age 1month to 15 years  presenting with seizure were included. The data was analyzed using SPSS 16.0. Results: Out of 192 patients,126 (65.6%) were males and 66(65.6%) were females with the ratio of 1.9:1. Distribution of events in different age groups were 16.1%(n=31) in group of 1month to 1 years, 63%(n=121) in group of 1yrs to 5 years,12.1%(n=24) in group of 5years to 10 years and 8.3%(n=16)in  children above 10years.70.3% had febrile seizure, with the highest incidence in age group of 1 to 5 years. Generalised tonic clonic seizure was seen in 94.3% and focal motor seizure in 5.7%. No difference was seen  in distribution of the type of seizure across different age groups (p= 0.192).Presenting complaints were fever in 75.5%, loss of consciousness in 26.0%, vomiting in 25.0% , headache in 23.4%, altered sensorium in 8.3% and focal neurological deficits in 8.3%. 33.9% of children had a family history of seizure. Causes of febrile seizures included upper respiratory tract infection in 82.2%, acute gastroenteritis  in 12.6%, urinary tract infection in 3% and pneumonia  in 2.2%. Afebrile seizure was idiopathic in 38.6% and identifiable causes in the remaining were sequelae of birth asphyxia in 17.6%, hypoglycemia in 8.8%, neuronal migration defects and neurocysticercosis in 5.3%. No relation was observed  between the history of perinatal asphyxia and the age of onset of seizure (p=0.250). Of all the patients 57.8% were discharged without antiepileptic, 27.6% were treated with monotherapy whereas 14.5% required polytherapy to achieve seizure control. Conclusions: Seizure is  a common problem in children, with the highest incidence in the age group of 1 to 5 years and  febrile seizure is  the most common type of seizure in children.  

scholarly journals A study of clinical profile of intractable epilepsy in children

2020 ◽  
Vol 7 (3) ◽  
pp. 664
Author(s):  
C. Bhanu Sree ◽  
Gangadhar B. Belavadi
Keyword(s):  
Febrile Seizure ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Intractable Epilepsy ◽  
Birth Asphyxia ◽  
Good Control ◽  
Care Hospital ◽  
Number Of Children ◽  
Risk Pregnancy ◽  
History Of

Background: This study was undertaken to find out the prevalence and clinical features of intractable epilepsy (IE) in a tertiary referral center.Methods: Study was conducted in a tertiary care hospital on 60 children with intractable epilepsy. Cases includes  intractable epilepsy is when seizures continue to occur despite maximally tolerated doses of more than two antiepileptics, occurrence of an average of one seizure per month for 18 months with no more than a 3 month seizure free period during these 18 months. Controls: epileptic children who had good control of seizures for the previous 18 months.Results: The prevalence of intractable seizures was 10% with maximum number of children 25 (41.6%) belonged to the 5-12 years. 15 (50%) children had daily seizures. Myoclonic seizures proved to be an important predictor of intractability. 4 children among the cases had history of family seizures, 6 children in cases had history febrile seizure, whereas, 6 children among the controls had history of family seizures, 8 children in controls had history febrile seizure.  23.3% of children presented with Status epilepticus in the cases and 16.6% of the children in the controls. Remote symptomatic etiology 12(40%) is the commonest cause of seizure. 13 (43.3%) children in cases and 3 (10%) children among the controls had a history suggestive of birth asphyxia. EEG was abnormal in 17 (56.6%) cases when compared to 11 (36.6%) children in the controls. CT scan was abnormal in 14 (46.6%) cases and 10 (33.3%) controls. MRI was abnormal in 16 (53.3%) children of the cases and 8 (26.6%) children of the controls.Conclusions: The commonest cause of intractable epilepsy was perinatal asphyxia. Perinatal asphyxia can be prevented by good nutrition during pregnancy, regular antenatal check ups with detection of high risk pregnancy, promoting hospital deliveries and prompt resuscitation of newborn when required. 

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
Keyword(s):  
Tertiary Care Hospital ◽  
Organophosphorus Compounds ◽  
Care Center ◽  
Tertiary Care ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Age Group ◽  
Psychiatric Illnesses ◽  
History Of ◽  
One Year

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

scholarly journals Clinicoepidemiological Profile of Childhood Poisoning in the Pediatric Unit of a Tertiary Care Hospital in North India

2019 ◽  
pp. 1-8
Author(s):  
Rahid Rasool Malla ◽  
Khalid Kawoosa ◽  
Meryem Juwhyreeyeh ◽  
Riyaz Ahmed Malik ◽  
Asif Ahmed ◽  
...  
Keyword(s):  
Parental Education ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Age Groups ◽  
Gastric Lavage ◽  
North India ◽  
Care Hospital ◽  
Age Group ◽  
College Hospital ◽  
Childhood Poisoning

Background: This study was conducted to find out the pattern of poisoning cases among the pediatric population in Srinagar and its Northwestern suburbs and compare it with what occurs elsewhere in India. Thereby we aimed to provide practical knowledge in dealing with these pediatric patients. Methods: The hospital records of children between the ages of 0-19 years admitted to the pediatric emergency ward of SKIMS Medical College Hospital Srinagar with poisoning from July 2016 to June 2018 were evaluated. Results: A total of 154 cases of poisoning were admitted in the study period, of which 89(57%) were males and 69(43%) were females. In the 0-12 year age group the poisonings were mostly in boys (68.26%) and were accidental whereas in the 13-19 year age group poisonings were mostly in girls (64%) and due to suicidal attempts. Organophoshorus poisoning was the most commonly ingested poison across all age groups (44.8%) followed by rodenticides (16.23%), kerosene (13.63%) and medications (11.68%). Interventions mostly commonly done were gastric lavage, induced vomiting. Mortaliy was seen in 2 cases over 2 years (1.29%). Conclusion: Knowledge on epidemiological and clinical features of poisoning in children according to age groups, establishing safety standards for sale and storage of harmful chemicals, and parental education can help to decrease the burden of childhood poisoning.

scholarly journals Association of Vesicoureteric Reflux (VUR) in Children with Symptomatic Urinary Tract Infection (UTI) - in a Tertiary Care Hospital, Dhaka, Bangladesh

2013 ◽  
Vol 37 (2) ◽  
pp. 79-84
Author(s):  
Afroza Begum ◽  
Habibur Rahman ◽  
MM Hossain ◽  
Golam Muinuddin ◽  
Ranjit Ranjan Roy ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Renal Scarring ◽  
Tertiary Care ◽  
Vesicoureteric Reflux ◽  
Pediatric Nephrology ◽  
Care Hospital ◽  
Age Group ◽  
Micturating Cystourethrogram

Background: Vesicoureteric reflux is the most common urinary tract anomaly affecting the children which predisposes to higher rates of urinary tract infection and renal scarring than those without VUR. Objective: To find out the associations of VUR in children presented with UTI. Methodology: This cross sectional study was conducted in 36 children aged 1 month to 16 years who were admitted due to UTI in the Pediatric Nephrology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2009 to June 2010. UTI were evaluated by urinalysis, culture and sensitivity test, ultrasonography of the urinary system with post-voidal residue and micturating cystourethrogram subsequently. Results: This study revealed that UTI were most frequent in boys (P<0.001). Maximum number 19(52.7%) of UTI cases were detected between 12 months -60 months age group of children. Highest number of bilateral hydronephrosis 7(71.43%) and VUR 12(63.15%) were also detected in the were detected in 2-23 months age group of children. Maximum number of 22/38 kidneys (57.90%) with refluxing units were detected between 12 months to 60 months (1-5 years) age group and out of this 16(72.72%) units are of severe grades. Conclusion: Children presented with UTI along with features of obstructive- uropathy must be investigated early and carefully for VUR to prevent recurrent UTI and renal damage. DOI: http://dx.doi.org/10.3329/bjch.v37i2.17264 BANGLADESH J CHILD HEALTH 2013; VOL 37 (2) : 79-84

scholarly journals Factors influencing perforated appendicitis in a tertiary care hospital

2017 ◽  
Vol 4 (6) ◽  
pp. 1918
Author(s):  
Palachandra A. ◽  
Shashank R. ◽  
Sreelatha C. Y.
Keyword(s):  
Acute Appendicitis ◽  
Tertiary Care ◽  
Age Groups ◽  
Delayed Diagnosis ◽  
Perforated Appendicitis ◽  
Life Time ◽  
High Morbidity ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional

Background: Appendicitis is among the most common abdominal conditions requiring admission to emergency surgery departments. It has a life time risk of 6%. Untreated appendicitis may be complicated with development of gangrene or perforation, resulting in high morbidity and mortality rates in almost all age groups. The frequency of appendicitis may show variation by population, age, sex, socioeconomic status, and race. The objective of this study was to know the influence of some demographic factors on perforated appendicitis in a tertiary care hospital.Methods: A descriptive cross sectional was done in a teaching hospital which is a referral center. All the acute appendicitis cases admitted to the hospital between January 2015 to December 2016 were included in the study. A total of 532 acute appendicitis cases were diagnosed based on pathological features and were allocated to either the perforated or non-perforated appendicitis groups.Results: In our study total 532 cases were operated for appendicitis. Among that 294 (56%) were males and 238 (44%) were females with a ratio of 1.27:1.00. The mean age was 26.8±13.2 among non -perforated cases and 22.4±12.3 among perforated cases. In present study, maximum cases were in the age group 21-30 years and perforation was more among >50 years age group (23.3%).Conclusions: Perforation was higher among >50 years age group and in the patients from rural area which was found to be statistically significant. The reasons can be misdiagnosis, delayed diagnosis, financial and transportation problems.

scholarly journals LOW VISION DEVICES

2015 ◽  
Vol 22 (10) ◽  
pp. 1345-1350
Author(s):  
Muhammad Saad Ullah ◽  
Sohail Safdar ◽  
Muhammad Nabeel Ahmad
Keyword(s):  
Tertiary Care Hospital ◽  
Low Vision ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Hospital ◽  
Age Group ◽  
Vision Assessment ◽  
Study Results ◽  
Two Age Groups

Objective: The main objective of the present study was to find out visual outcomeof Low Vision Devices among patients suffering from different diseases causing reduced visualacuity in the area of Dera Ghazi Khan, Southern Punjab, Pakistan. Setting: OphthalmologyDepartment, Dera Ghazi Khan which is a tertiary care hospital. Period: 10th February, 2014 to31st December, 2014. Material and Methods: Patients (n=55) presented for their low visionassessment included two groups age wise as patients equal or more than 18 years age (n=22)and patients less than 18 years (n=33). LOG MAR VA charts, contrast sensitivity test, visualfields through arc perimeters, color vision with color pencils hue 16 test along with objective andsubjective refractions were applied. All the data were entered and analyzed using SPSS version16.00. Results: Patients (n=55) aged 7-90 years presented for their low vision assessment hadmean age 23.73+ 2.9 years. The patients were divided into two age groups. First group was22 (40%) patients equal or more than 18 years age and second consisted of 33(60%) patientsless than 18 years age group. Among the patients examined, 40 (72.7%) were males and 15(27.3%) were females. Our study results revealed that the low vision devices provision wasassociated with a statistically significant improvement in both near and distance visual acuitiesand with patients’ fulfillment. Conclusion: There was a significant improvement in far and nearvisual acuity of the patients suffering from a multiplicity of blindness caused diseases by whichpatients are able to improve their quality of life and able to do their tasks without getting helpfrom others.

scholarly journals A Documentation of Hepatitis Outbreak in Chittagong

2019 ◽  
Vol 17 (2) ◽  
pp. 2-5
Author(s):  
Rajat Sanker Roy Biswas ◽  
Fahim Ul Hasan ◽  
Aklima Sultana ◽  
Md Kamal Uddin ◽  
Debashis Chowdhury ◽  
...  
Keyword(s):  
Hepatic Failure ◽  
Demographic Data ◽  
Tertiary Care ◽  
Age Groups ◽  
Hepatitis E ◽  
Uneventful Recovery ◽  
Care Hospital ◽  
Younger Age ◽  
History Of ◽  
Dark Color

Introduction: Hepatitis E Virus (HEV) causes outbreaks of jaundice and it is associated with morbidity and higher maternal mortality. There is a recent outbreak of hepatitis in the Chittagong city and present study is aimed to observe the clinical and serological trends along with outcome of hepatitis cases visiting two tertiary care hospitals Chittagong, Bangladesh. Methods: It was an observational study done in two tertiary care hospital of Chittagong in a period of 3 months (May, June & July 2018) among 230 patients of hepatitis. After inclusion with written informed consent patients were introduced a questionnaire. Their demographic data, risk behaviors were noted, history related to hepatitis were recorded. Examination was done and evaluation regarding presence of hepatic encephalopathy at bed site was noted. Later serological findings were evaluated. After collection of all data it were compiled and analyzed by SPSS- 20. Results: Among 230 cases age group, gender and locality of the study patients were analyzed where younger age groups specially 21-30 years 114(49.6%) and 31-40 years 38(16.5%) were the most affected group. Gender distribution was found mostly same. Halishahar area which is located in western part of the Chittagong city was found mostly affected 196(85.2%). Use of water from WASA (Water and Sewerage Authority) supply was 168(73%) and deep tubewel water was 56(24.3%). Among them 80(34.8%) subjects do not boil water Anorexia (74.8%) nausea (77.4%) vomiting (83.5%) history of fever (89.6%) passage of dark color urine (99.1%) and weakness (97.4%) were some common presenting complaints. Family history of jaundice was found in 40.9% of cases. Among all 216(93.91%) had clinical jaundice, 91(39.56%) had right upper quadrant of the abdomen pain, 41(17.8%) had hepatomegally, 14(6.1%) had spleenomegally, 24(10.4%) had signs of hepatic failure and 34(14.8%) female were pregnant. Anti HEV was found positive in 164(71.3%) cases, 12(5.2%) were positive for anti HAV, 6(2.6%) were positive for HBsAg. None was found anti HCV positive. Among all 4(1.8%) cases died due to hepatic failure or multi-organ failure with AKI. All of them were pregnant. Two pregnant lady had missed abortion. Among all 11(4.7%) cases loosed follow and 213(92.60%) cases had uneventful recovery. Conclusion: This outbreak of HEV was of usual pattern of morbidity and mortality, and therefore points to water supply and sanitation issues. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 2-5

MORPHOLOGICAL EVALUATION OF ANAEMIA CASES IN DIFFERENT AGE GROUPS IN A TERTIARY CARE HOSPITAL IN CENTRAL INDIA

2020 ◽  
pp. 59-60
Author(s):  
Arti Gupta ◽  
Pankaj Kumar Gupta ◽  
Pushpendra Kumar Gupta ◽  
Abhishree Geda
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Developed Countries ◽  
Reproductive Age ◽  
Care Hospital ◽  
Age Group ◽  
Adult Females ◽  
Microcytic Hypochromic Anaemia ◽  
Hypochromic Anaemia ◽  
Developing And Developed Countries

Introduction: Anaemia is prevalent clinical condition in both developing and developed countries so it needs constant evaluation. As morphological study of red blood cell is initial and cheep tool for approach to causative factors here is an attempt to evaluate morphological distribution of anaemia. Aims and objectives: 1-To study distribution of anaemia in different age and sex category. 2-To determine morphological pattern of anaemia in all age groups. Material and Methods: A total of 752 anaemic samples were studied by peripheral smear examination, Samples were also run in automated cell counter to nd red cell parameters WHO Criteria were used as cut off for haemoglobin concentration Results: Among Seven hundred fty two cases , paediatric age group include 92 cases (12.23%), adult male aged 12 to 65 years include 160 patients (21.27%) , adult female aged 12 to 65 years was 476 ( 63.29%) and elderly patients more than 65 years was 24 (3.19%).Among all 752 cases 311 patients (41.3%) were having microcytic hypochromic anaemia Conclusion: To conclude in our study maximum numbers of cases are observed in adult females in reproductive age group. In both adult females and children maximum number of cases is having microcytic hypochromic anaemia due to iron deciency. So it is important to focus on screening, early dietary modication and supplemental therapy to reduce anaemia prevalence in the developing and developed countries.

scholarly journals Prevalence of microorganisms causing catheter associated urinary tract infections (CAUTI) among catheterised patients admitted in a tertiary care hospital

2017 ◽  
Vol 5 (6) ◽  
pp. 2367 ◽  
Author(s):  
Vinoth M. ◽  
Prabagaravarthanan R. ◽  
Bhaskar M.
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bacterial Colonization ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Hospital ◽  
Cross Sectional ◽  
Tract Infections

Background: Catheter-associated urinary tract infection (CAUTI) is an important cause of morbidity and mortality in Indian subjects, affecting all age groups. Bacteriuria orcandiduria is almost inevitable in nearly half of the patients who require an indwelling urinary catheter for more than 5 days. The objective of this study was to find the prevalence of CAUTI infection and to determine their antibiotic profileMethods: The present cross-sectional study included 50 patients admitted to medicine and surgery wards in our hospital. The urine from catheter is collected from each patient and subjected to culture and antibiotic susceptibility testing.Results: The prevalence of catheter associated urinary tract infection in our hospital is about 20% and asymptomatic bacterial colonization is 50% which is nearequal to Danchaivijitr S et al study. The common pathogens found in this study are Escherichia coli (22%), Klebsiella (18%), Enterobacter (8%), Staph. aureus (6%) which include MRSA (4%), Pseudomonas (6%), Enterococcus (4%), Candida sps. (4%) Andproteus (2%).Conclusions: CAUTI has low prevalence 20% and asymptomatic colonisation 50% in our hospital with common pathogen being Escherichia coli. It is one of the important notable pathogen causing nosocomial infection among admitted patients. The patients present mainly as asymptomatic bacterial colonisation and risk of CAUTI increases with longer duration of catheterisation. All patients those who had catheter for more than 6 days, aged 60 and above, should be checked for UTI symptoms. And their urine should be cultured regularly in order to diagnose and prevent CAUTI and its complications which are very dangerous and difficult to treat.

scholarly journals Profile of neonatal dermatoses in a tertiary care teaching hospital of Haryana

2018 ◽  
Vol 6 (3) ◽  
pp. 955
Author(s):  
Poonam Marwah ◽  
Ashish Marwah ◽  
Sunil Kumar ◽  
Rajesh Kumar
Keyword(s):  
Birth Weight ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Age Group ◽  
Common Skin ◽  
History Of ◽  
Recorded Data

Background: To assess the incidence and profile of neonatal dermatoses in a tertiary care hospital of Haryana and study its association with various perinatal risk factors.Methods: All inborn neonates (<28 days of life) including those seen in the outpatient department on follow up between November 2016 to April 2017 formed the baseline population and babies with skin lesions were included in the study. A detailed perinatal history and newborn examination of the baby was done by a pediatrician and all relevant details were recorded. Data was analyzed, and inferences were drawn using tables.Results: In our study, a total of 2760 newborn (1506 (54.6%) males and 1254 (45.4%) females) were studied. The incidence of neonatal dermatoses was found to be 94.1%. There were 1849 (66.9%) term, 853 (30.9%) preterm, and 58 (2.1%) post term neonates. 1901 (68.8%) had birth weight >2.5kg while 859 (31.1%) had birth weight ≤2.5kg. 1223 (44.3%) were born to primipara while 1537 (55.6%) were born to multipara mothers. Mothers of 54 (1.9%) neonates were < 20 years of age; 1157 (41.9%) in the age group of 20-25 years; 1324 (47.9%) in the age group of 25-30 years and 225 (8.1%) in the age group >30 years. 1806 (65.4%) neonates were born by normal vaginal delivery and 954 (34.6%) neonates were born by cesarean section. In 13 (0.5%) neonates, history of consanguinity was present while it was absent in 2747 (99.5%) neonates. Most common skin lesions observed were transient skin lesions among which Mongolian spots (62.9%), epstein pearls (48.8%), erythema toxicum (41.8%), milia (40.6%) and miniature puberty (35.9%) were the most common.Conclusions: Incidence of neonatal dermatoses was found to be higher (54.6%) among males as compared to females (45.4%); among term babies; those with birth weight >2.5kg; those born to multipara mothers; those born via normal vaginal delivery and those with maternal age 25-30 years.

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