scholarly journals A Descriptive study of referral in Department of Psychiatry in Tertiary Hospital in Nepal

2014 ◽  
Vol 2 (2) ◽  
pp. 22-25
Author(s):  
M Chapagai ◽  
KM Dangol ◽  
SP Ojha ◽  
M Rana ◽  
P Tulachan
Keyword(s):  
Descriptive Study ◽  
Tertiary Hospital ◽  
University Teaching ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Organic Mental Disorders ◽  
The Mean ◽  
Definition Of ◽  
Inpatient Units ◽  
Mental And Behavioral Disorders

Background There are many definition of liaison psychiatry. The American Academy of psychosomatic medicine has suggested the term “medical and surgical psychiatry”. Much of the literature on Consultation Liaison (C-L) Psychiatry concerns the psychiatric assessment and management of patients in a general hospital.   Method This was a descriptive study consisting of all the cases referred for liaison psychiatric consultation from inpatient units of various departments of Tribhuvan University Teaching Hospital, between October 2012 to April 2013. Patients of any age and of either gender were included.   Result A total of 95 patients were referred from different departments of the hospital for liaison psychiatric consultation within the 6 months period. Majority of the subjects were male .The mean age of the subjects was 42.47 years (±19.98). Neurotic and stress-related disorders were seen associated with female.   Conclusion: Mainly young adults and adult between 21-50 years of age are referred for liaison. Neurotic and stress-related disorders (30.5%), organic mental disorders (27.4%) and mental and behavioral disorders due to substance use cases (16.8%) were mainly referred for liaison psychiatric consultation. DOI: http://dx.doi.org/10.3126/jpan.v2i2.9721   J Psychiatrists’ Association of Nepal Vol.2, No.2, 2013 22-25     

scholarly journals Pattern of psychiatric morbidity among referred inpatients in a tertiary care hospital of Bangladesh

2020 ◽  
Vol 31 (2) ◽  
pp. 38-42
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Sharmin Kauser ◽  
Mekhala Sarkar ◽  
Md Masud Rana Sarker ◽  
...  
Keyword(s):  
General Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Major Depressive ◽  
Consultation Liaison Psychiatry ◽  
The Mean ◽  
Inpatient Units

There is a dearth of studies related to consultation-liaison psychiatry in Bangladesh. The psychiatric referral rates in this country are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. This was a descriptive study consisting of all the cases referred for psychiatric consultation from inpatient units of various departments of BIRDEM General Hospital, Dhaka from July 2017 to June 2018. Patients of any age and of either gender were included. A total of 673 patients (1.97% of total admission) were referred from different departments of the hospital for psychiatric consultation within the study period. Majority of the respondents were female. The mean age of the respondents was 59.47 (±1.98) years. Among the referred, Generalized anxiety disorder (GAD) was the diagnosis in 24.96%, followed by Major depressive disorder (MDD) in 9.95% cases. Referral from the department of Medicine and allied was 92.86 %, followed by department of Surgery and allied (6.38%) & department of Obstetrics and Gynaecology (0.74%). Frequency of referral was the lowest in the months of November to January. There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity. Bang J Psychiatry December 2017; 31(2): 38-42

scholarly journals Renal Function in Patients with Hypertension Associated Congestive Cardiac Failure Seen in a Tertiary Hospital

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
C. U. Osuji ◽  
C. U. Nwaneli ◽  
B. J. Onwubere ◽  
E. I. Onwubuya ◽  
G. I. Ahaneku
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Failure ◽  
Tertiary Hospital ◽  
Congestive Cardiac Failure ◽  
University Teaching ◽  
Ethical Review ◽  
Serum Urea ◽  
Significant Difference ◽  
The Mean

Background. Chronic kidney disease is frequently seen in patients with congestive cardiac failure and is an independent risk factor for morbidity and mortality. The aim of this study was to determine the prevalence of chronic kidney disease in patients with hypertension associated congestive cardiac failure.Method. One hundred and fifty patients with hypertension associated congestive cardiac failure were recruited consecutively from the medical outpatient department and the medical wards of the Nnamdi Azikiwe University Teaching Hospital Nnewi over a one year period, January to December 2010. Patients’ biodata and medical history were obtained, detailed physical examination done and each patient had a chest X-ray, 12 lead ECG, urinalysis, serum urea and creatinine assay done. Ethical clearance was obtained from the Ethical Review Board of our institution and data analysed using SPSS-version 16.Results. There were 86 males and 64 females with mean age62.7±12.5years. The mean blood pressures were systolic152.8±28.5 mmHg and diastolic94.3±18 mmHg. 84.7% had blood pressure ≥140/90 mmHg on presentation. The mean GFR was70.1±31.3 mls/min. 76% of subjects had GFR <90 mls/min and no statistical significant difference between males and females,P=0.344. The mean serum urea was7.2±51 mmol/L while the mean serum creatinine was194±416.2 mmol/L.Conclusions. This study has demonstrated that majority of patients presenting with hypertension associated congestive cardiac failure have some degree of chronic kidney disease.

scholarly journals Prevalence and predictors of episiotomy and perineal tear at a tertiary hospital in Port-Harcourt, Nigeria

2020 ◽  
Vol 9 (11) ◽  
pp. 4595
Author(s):  
Peter A. Awoyesuku ◽  
Dickson H. John ◽  
Basil O. Altraide
Keyword(s):  
Birth Weight ◽  
Head Circumference ◽  
Developed Countries ◽  
Tertiary Hospital ◽  
University Teaching ◽  
State University ◽  
Perineal Tear ◽  
Vaginal Deliveries ◽  
Fetal Birth Weight ◽  
The Mean

Background: Despite many years of it being practiced, episiotomy has remained a controversial operation. The rate is on the decline in developed countries but remains high in developing countries. This study seeks to determine the prevalence of episiotomy and perineal tear, and to assess the associated factors, at the Rivers state university teaching hospital (RSUTH).Methods: A retrospective study over a two-year period, from 01 January 2018 to 31 December 2019, was carried out. All women who had singleton spontaneous vaginal deliveries (SVD) with episiotomy or perineal tear at the RSUTH with complete records were included, those with twin delivery and incomplete data were excluded. Data was retrieved from the birth registers and case notes using a proforma. Information on maternal age, parity, gestational age (GA), type of injury, birth weight, head circumference and Apgar scores were extracted. Data were analyzed using statistical package for the social sciences (SPSS) version 20.Results: There were 2150 vaginal deliveries, with 440 (20.5%) receiving episiotomy, while 21 (1.0%) had perineal tear. The mean age±standard deviation (SD) was 29.52±4.97 years, median parity was 1, and mean GA±SD was 37.35±1.71 weeks. The mean birth weight±SD was 3.33±0.52 kg and mean head circumference±SD was 34.76±1.90 cm. There was significant association between maternal parity and fetal birth weight with the occurrence of episiotomy and perineal tears.Conclusions: The rate of episiotomy and perineal tear was higher than recommended, with an increasing trend. The lower the parity and the higher the fetal birth weight, the likelihood to receive an episiotomy. More efforts are needed to reduce the rate.

scholarly journals Patterns Of Psychiatric Referrals In A Tertiary Hospital

2020 ◽  
Vol 9 (2) ◽  
pp. 48-52
Author(s):  
R Niroula ◽  
PK Chakrabortty ◽  
P Thapa ◽  
JB Khattri ◽  
K Ramesh
Keyword(s):  
Anxiety Disorder ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Somatoform Disorder ◽  
Care Hospital ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Medicine Department ◽  
Icd 10

Introduction: Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to patients under non-psychiatric care. Despite evidence of benefits of CLP for patients with psychiatric comorbidities, referral rates from hospital doctors remain low. This has prompted the present study, to assess the frequency and the pattern of psychiatric referral in a tertiary hospital in Nepal. Material And Method: This was a descriptive cross‑sectional study conducted in a tertiary care hospital. The study comprised of 108 patients referred for psychiatric consultation from various out-patient departments (OPD) to C‑L services of psychiatry department. Information was collected using semi‑structured proforma, and diagnosis was made based on Diagnostic Criteria for Research (ICD-10 DCR)and the data were analyzed. Results: A total of 108 patients, male 41(38%) and female: 67(62%) were referred to CLP, the Medicine department sent the maximum number of consultations (57.4%), followed by E.N.T (25.9%), Surgery (16.7%). Psychiatric consultation was sought for various reasons including decreased sleep (37%), appears anxious (27.8%), appears depressed (15.7%), foreign body sensation (11.1%), and mass moving in abdomen (8.3%).The most prevalent ICD-10 diagnosis was depressive episode (44.4%) followed by anxiety disorder (27.8%) and somatoform disorder (19.4%). Conclusion: Our study illustrates the importance of CLP through referral pattern from various OPD in a tertiary care hospital. Majority of referrals were from Medicine department andthe most common reason of referral was decreased sleep. The commonest diagnosis seen in the referred out-patients was depression followed by anxiety disorder and somatoform disorder.

Determination of Financial Competence in Consultation-Liaison Psychiatry

1993 ◽  
Vol 38 (9) ◽  
pp. 595-598 ◽  
Author(s):  
Nadia D. Toffoli ◽  
Nathan Herrmann
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
University Teaching ◽  
Surgical Patients ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry ◽  
Careful Documentation

The aging of our population will require physicians to become more aware of the issues surrounding the determination of financial competence. This retrospective study involved the review of 46 medical or surgical patients in a university teaching hospital that were referred to the psychiatric consultation-liaison team for assessment of financial competency. Charts were reviewed for completeness of documentation using suggested criteria for determination of financial competence. The study found that while many criteria were frequently documented, documentation was incomplete for important criteria, such as calculating abilities, judgement, the patient's appreciation of the consequences of financial competence, presence of delusions with regard to finances and the patient's awareness of debt. Concerns are expressed regarding a physician's ability to recall details pertaining to cases before a tribunal without complete and careful documentation. The importance of establishing formal criteria for the determination of financial competence is also discussed.

scholarly journals Distribution Pattern of Serum Uric Acid Level Before and After National Festival Dashain among Patients Visiting Tertiary Hospital, Kathmandu, Nepal

2020 ◽  
Vol 10 (2) ◽  
pp. 36-39
Author(s):  
Dipesh Tamrakar ◽  
Sabina Shakya ◽  
Sadikshya Shrestha ◽  
Salina Pradhananga ◽  
Vijay Kumar Sharma ◽  
...  
Keyword(s):  
Uric Acid ◽  
Distribution Pattern ◽  
Serum Uric Acid ◽  
Serum Uric Acid Level ◽  
Tertiary Hospital ◽  
University Teaching ◽  
P Value ◽  
Continuous Variables ◽  
Before And After ◽  
The Mean

Introduction: Dashain, one of the national festivals in Nepal, celebrated with excessive consumption of high purine content foods, alcoholic and soft beverages. These foods have been associated with higher Serum Uric Acid (SUA) levels leading to hyperuricemia. This study was intended to evaluate the distribution pattern of SUA level a month before and after this festival for two consecutive years.   Methods and Materials: The data of 5818 patients visiting Clinical Biochemistry Laboratory, Tribhuvan University Teaching Hospital for SUA test (a month before and after Dashain festival for two consecutive years; 2017 - 2018 A.D.) were collected and analyzed. The statistical analysis was done using SPSS version 21. Continuous variables were expressed as mean ± SD taking 95% confidence interval and p values of <0.05 was considered to be statistically significant. Mann-Whitney U test was used to compare the variables.   Results: The mean SUA levels before and after Dashain in two consecutive years were 333.5 ± 112.1 μmol/L and 334.2±114.7 μmol/L in 2017 A.D. and 322.6 ± 103.9μmol/L and 343.2± 111.4 μmol/L in 2018 A.D. There was a significantly elevated level of the mean SUA level after Dashain festival in 2018 among both sexes (p-value <0.05). The age-wise distribution of mean SUA after the Dashain festival was consistent with increasing age among the study population.   Conclusion: The study concluded that the Dashain festival has an impact on increasing the SUA level.  

Current Trends in Consultation-Liaison Psychiatry*

1983 ◽  
Vol 28 (5) ◽  
pp. 329-338 ◽  
Author(s):  
Z.J. Lipowski
Keyword(s):  
Mental Health Problems ◽  
Surgical Patients ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
The Past ◽  
Current Trends ◽  
Research Activities ◽  
History Of ◽  
Consultation Liaison Psychiatry ◽  
Definition Of

Consultation-liaison psychiatry has grown rapidly and become a subspecialty of psychiatry in the past decade. The author reviews the history of this field at the interface of psychiatry and medicine, offers its definition, and discusses current trends pertaining to the organization of liaison services and to the teaching and research activities of liaison psychiatrists. He concludes that a liaison service has become a recognized division of a general hospital psychiatric unit for the provision of psychiatric consultation and teaching to the nonpsychiatric departments of the hospital. Consultation-liaison psychiatry (or liaison psychiatry for short) has emerged in the past decade as a subspecialty of psychiatry, one concerned with mental health problems among medical and surgical patients. Diagnosis, treatment, study and prevention of psychiatric disorders in those patients constitute the proper domain of liaison psychiatry. I will review in this article the major current trends in this field as they pertain to matters of organization, education, and research. A brief historical note and a definition of liaison psychiatry will introduce my review.

scholarly journals Clinical characterisation and management outcomes of COVID-19 infection in pregnancy in a Nigerian tertiary hospital

2021 ◽  
Vol 10 (10) ◽  
pp. 3691
Author(s):  
Omotade A. Ijarotimi ◽  
Akaninyene E. Ubom ◽  
Ibraheem O. Awowole ◽  
Ekundayo O. Ayegbusi ◽  
Oluwafemi Kuti
Keyword(s):  
Perinatal Outcomes ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Categorical Variables ◽  
Chi Square ◽  
The Mean ◽  
Sub Saharan ◽  
In Pregnancy

Background: Literature on the antenatal and perinatal management and outcomes of COVID-19 infection in pregnancy in Nigeria and sub-Saharan Africa is gradually emerging but sparse. There is an urgent need to build up the knowledge base of COVID-19 infection in Nigerian pregnant women. The objective of the current study was to determine the clinical characteristics and management outcomes of COVID-19 infection in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.Methods: A one-year retrospective review of all cases of COVID-19 infection in pregnancy managed at the OAUTHC. Relevant data were extracted from the case records of all cases managed using a purpose-designed proforma. Data collected was analysed using IBM-SPSS, version 24. Associations between categorical variables were assessed using chi square, with level of significance set at <0.05.Results: A total of 22 cases were managed. Majority (15, 68.2%) of the women were either asymptomatic or had mild symptoms. The commonest symptom was cough (8, 36.4%). The mean duration of admission was 6.6±4.2 days. The most common maternal and perinatal complication was preterm delivery/birth (3, 13.6%). There was no maternal mortality. The mean birth weight of the babies was 3226g±597g, with mean 1- and 5- minutes Apgar scores of 8.0±1.3 and 9.5±0.6 respectively.Conclusions: Although COVID-19 infection in pregnancy is an asymptomatic or mild infection in the majority of cases in Ile-Ife, Nigeria, it is associated with adverse maternal and perinatal outcomes. Further studies are recommended to determine transplacental transmission of COVID-19 infection and antibodies.

scholarly journals Risk factors for mortality among Human Immuno Virus infected children on antiretroviral therapy

2019 ◽  
Vol 6 (6) ◽  
pp. 2260
Author(s):  
Sunil Bule ◽  
Minal Wade
Keyword(s):  
Risk Factors ◽  
Social Factors ◽  
Growth Parameters ◽  
Clinical Stage ◽  
Descriptive Study ◽  
Tertiary Hospital ◽  
Advanced Clinical Stage ◽  
Duration Of Therapy ◽  
The Mean ◽  
Poor Outcomes

Background: Children infected with HIV often reach the health care well after progression to severe immunosuppression which results in higher morbidity and mortality as compared to adults. They are vulnerable to faster disease progression compounded by susceptibility infections and social factors like attrition of caretakers. The present study delineates the factors for poor outcomes among HIV infected children.Methods: The records of HIV infected children from 1 to 15 years of age, started on HAART, registered at ART Centre at a tertiary hospital were reviewed in the Retrospective descriptive study. The demographic details, growth parameters, clinical features, WHO staging and investigations were assessed to study the risk factors for mortality in these children.Results: Amongst the 205 HIV infected children, enrolled in the study, the incidence of mortality was 27/205 (13.7%). The mean age of HIV infected children on ART in the no mortality and mortality group was 8.19 years and 8.25 years. The mean WHO stage of HIV infected children on ART in no mortality and mortality groups at the start of the study was 2.75 (SD=0.89) and 3.66 (SD=0.48), respectively. The mean CD4 count at start in the mortality group (195.85±105.57 cells/mm3) is significantly lower as compared to the no mortality group (306.2+355.66 cells/mm3). The mean grade of malnutrition in the no mortality and mortality groups was 1.84 and 2.88, respectively. Tuberculosis was present in 48.78% at start.Conclusions: Presence of advanced clinical stage, immunosuppression, poor nutritional state, and shorter duration of therapy are important factors deciding outcome of the children on HAART. The intense monitoring in period post starting of HAART will ensure better outcomes.

Comparison of Fluorine(18)-fluorodeoxyglucose and Gallium(68)-citrate PET/CT in patients with tuberculosis

2019 ◽  
Vol 58 (05) ◽  
pp. 371-378
Author(s):  
Alfred O. Ankrah ◽  
Ismaheel O. Lawal ◽  
Tebatso M.G. Boshomane ◽  
Hans C. Klein ◽  
Thomas Ebenhan ◽  
...  
Keyword(s):  
Tracer Uptake ◽  
Pet Ct ◽  
The Mean ◽  
18F Fdg ◽  
Definition Of ◽  
Gallium 68 ◽  
Attending Physician ◽  
Pet Scans ◽  
The Brain

Abstract 18F-FDG and 68Ga-citrate PET/CT have both been shown to be useful in the management of tuberculosis (TB). We compared the abnormal PET findings of 18F-FDG- and 68Ga-citrate-PET/CT in patients with TB. Methods Patients with TB on anti-TB therapy were included. Patients had a set of PET scans consisting of both 18F-FDG and 68Ga-citrate. Abnormal lesions were identified, and the two sets of scans were compared. The scan findings were correlated to the clinical data as provided by the attending physician. Results 46 PET/CT scans were performed in 18 patients, 11 (61 %) were female, and the mean age was 35.7 ± 13.5 years. Five patients also had both studies for follow-up reasons during the use of anti-TB therapy. Thirteen patients were co-infected with HIV. 18F-FDG detected more lesions than 68Ga-citrate (261 vs. 166, p < 0.0001). 68Ga-citrate showed a better definition of intracerebral lesions due to the absence of tracer uptake in the brain. The mean SUVmax was higher for 18F-FDG compared to 68Ga-citrate (5.73 vs. 3.01, p < 0.0001). We found a significant correlation between the SUVmax of lesions that were determined by both tracers (r = 0.4968, p < 0.0001). Conclusion Preliminary data shows 18F-FDG-PET detects more abnormal lesions in TB compared to 68Ga-citrate. However, 68Ga-citrate has better lesion definition in the brain and is therefore especially useful when intracranial TB is suspected.

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