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

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 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

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 Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043814
Author(s):  
Mesfin Tadese ◽  
Andargachew Kassa ◽  
Abebaw Abeje Muluneh ◽  
Girma Altaye
Keyword(s):  
Risk Factors ◽  
Academic Performance ◽  
University Students ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Point ◽  
Significant Difference ◽  
Associated Risk Factors

ObjectivesThe study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.Design and methodInstitution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.Setting and participantsEthiopia (2019: n=647 female university students).OutcomesThe primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.ResultsThe prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).ConclusionsDysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

scholarly journals Seroprevalence of Brucellosis and Associated Risk Factors among Indigenous Breeds of Goats in Wukari, Taraba State, Nigeria

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Olaolu T. Olufemi ◽  
Danjuma B. Dantala ◽  
Paul A. Shinggu ◽  
Umesi A. Dike ◽  
Gbeminiyi R. Otolorin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
The Public ◽  
Factors Associated ◽  
Males And Females ◽  
Associated Risk Factors ◽  
La Jolla

A cross-sectional study was conducted in Wukari, Taraba state, Nigeria, to determine the prevalence of Brucella antibodies and the risk factors associated with brucellosis in indigenous breeds of goats. A total of 386 goats were sampled from three political wards: Puje, Avyi, and Hospital: harvested sera samples were subjected to Rose Bengal Plate Test (RBPT). GraphPad Prism version 7.03 for Windows (GraphPad Software, La Jolla California, USA) was used to analyse the association between seroprevalence of brucellosis and age, sex, breed, location, and management system by using Chi square and Fisher’s exact test as appropriate. Brucellosis was detected in all three wards: Puje; 15%, Avyi; 6.6%, and Hospital; 7.6%. A prevalence rate of 2.8%, 8%, 18.7%, and 1% was recorded for <20-month, 22-35-month, 36-45-month, and ≥46-55-month age categories, respectively (P < 0.05). Only 9.5% was observed for male animals while 9.8% was observed for female animals with no statistical difference between the males and females. Breed-specific seroprevalence yielded 7.4%, 5.4% 12%, 12.8%, and 11.6%, for Cross, West Africa Dwarf, Red Sokoto, Kano Brown, and Sahel breeds of goat, respectively. There is an evidence of brucellosis (9.6%) in Wukari L.G.A, Taraba State, and age is a risk factor for the disease in the study area. There is a need to enlighten the public on the zoonotic potentials and economic impacts of brucellosis.

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 CLINICAL PROFILE OF ISOLATED SYSTOLIC HYPERTENSION AND IT'S CARDIOVASCULAR AND RENAL COMPLICATIONS AT AIIMS, PATNA, BIHAR

2020 ◽  
pp. 40-42
Author(s):  
Rajeev Ranjan Kumar ◽  
Shiv Kumar ◽  
Ravikirti Ravikirti ◽  
Debarshi Jana
Keyword(s):  
Risk Factors ◽  
Creatinine Clearance ◽  
Systolic Hypertension ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Isolated Systolic Hypertension ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Associated Risk Factors

Hypertension, its risk factors and complications is very poorly understood therefore it goes undiagnosed and untreated for a long time. The present study was undertaken to study the clinical profile of isolated systolic hypertension (systolic > 140 and diastolic ≤ 90 mmHg ) in elderly (above the age of 60 years)and to find out any other associated risk factors, any end organ complications, specially cardiac through electrocardiography and echocardiography and on kidney through creatinine clearance. The present cross-sectional study was undertaken on patients attending the outdoor department and indoor department of medicine. The study group comprised of 75 elderly patients who had isolated systolic hypertension (ISH). Using Chi square test correlation of age with stage of BP, association of risk factors with ISH and Stage III BP and ECG changes with LVH calculated. It concluded that ISH associated with risk factors has definite effect mainly on cardiac in terms of LV hypertrophy and on kidney in terms of reduced creatinine clearance and is an even better predictor of mortalityand morbidity than is diastolic blood pressure.

scholarly journals PREVALENCE OF BOVINE FACIOLOSIS IN HALABA MUNICIPAL ABATTOR SOUTHERN ETHIOPIA

2016 ◽  
Vol 4 (11) ◽  
pp. 82-91
Author(s):  
Muna Abdella ◽  
WubitTafese Mhatebu
Keyword(s):  
Risk Factors ◽  
Body Condition ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Southern Ethiopia ◽  
Multivariable Logistic Regression Analysis ◽  
Cross Sectional ◽  
Significant Difference ◽  
Prevention And Control Measures ◽  
Associated Risk Factors

A cross-sectional study was carried out from November 2015 to march 2016 on bovine fasciolosis, to assess the abattoir based prevalence, predominant species of bovine fasciolosis and associated risk factors of the disease in cattle slaughtered in Halaba municipal abattoir. A total of 384 cattle were examined using post mortem examination. Infection rates were (3.64%), 2.34%, 2.08%, and 1.82 % F. gigantic, F. hepatica, mixed and immature respectively with the overall prevalence of 9.88 % (38). F. gigantic was found to be the most prevalent species in cattle of the study area. Multivariable logistic regression analysis showed that the risk of fasciola infection was significantly higher in poor body condition animals than in medium and good body condition animals (p < 0.05). However, in terms of age, sex and breed, no statistically significant difference was found between infected animals (p > 0.05).The present study showed that bovine fasciolosis is one of the important pathogens in cattle in the study area and warrants appropriate disease prevention and control measures and further epidemiological investigations to determine the different agro ecological risk factors on the occurrence of the disease.

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

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