scholarly journals Age-at-onset and association with clinical features in bipolar inpatients: A case-records-based study from a tertiary hospital in eastern part of Nepal

2017 ◽  
Vol 4 (2) ◽  
pp. 20-24
Author(s):  
B.R. Adhikari ◽  
S.K. Mishra ◽  
S. Nepal ◽  
M. Basnet
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Late Onset ◽  
Tertiary Care ◽  
Age At Onset ◽  
Tertiary Hospital ◽  
Psychotic Symptoms ◽  
Published Data ◽  
Care Hospital ◽  
Clinical Variables

Introduction: There are suggestions that age-at-onset (AAO) of bipolar disorder may differ geographically and (AAO) may influence the clinical characteristics. Lack of any published data from eastern part of Nepal prompted this studyObjective: The aim of the study was to find the mean AAO in admitted patients in a tertiary care hospital from eastern part of Nepal and to study the association of clinical variables with AAO.Method: Retrospective analysis was done of bipolar in-patients’ case-records (N=229) who were discharged from 2012 to 2014. Diagnosis was based on International Classification of Diseases, Clinical Descriptions and Diagnostic Guidelines, tenth version (ICD-10). All variables from files were noted in a Performa prepared by the department for the purpose. Mean AAO was determined. The association of early-onset (below or equal to 18 years of age) and late-onset (later than 18 years) with clinical variables (comorbidity, family history, lifetime presence of psychosis and suicidal attempts) was assessed with Chi-Square test (0.05).Result: Mean AAO was 23.97 (SD 8.7) years. AAO was significantly associated with comorbidity and not significantly associated with family history of bipolar disorder, lifetime presence of psychotic symptoms or suicidal attempt(s).Conclusion: AAO and comorbidity are associated. Present findings need to be seen with the limitation of the study.

scholarly journals Role of Age at Onset in the Clinical Presentation of Bipolar Disorder

2021 ◽  
Author(s):  
Ajitabh Soni ◽  
Paramjeet Singh ◽  
Raghav Shah ◽  
Sunil Kumar ◽  
Lalit Batra
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Rating Scale ◽  
Clinical Presentation ◽  
Late Onset ◽  
Age At Onset ◽  
P Value ◽  
Young Mania ◽  
Thought Disorders ◽  
History Of

Introduction: There is considerable evidence to suggest that the clinical expression of Bipolar Disorder (BD) differs according to Age at Onset (AAO) that has therefore been identified as a potential specifier of interest. Aim: To compare the clinical presentation of BD and also to compare the presence of family history of illness in three subgroups made on the basis of AAO. Materials and Methods: A cross-sectional hospital based observational study was carried out on 162 patients having a diagnosis of BD current episode manic. Three subgroups were made according to AAO viz., Early Onset Bipolar Disorder (EOBD; AAO ≤21 years; 67 patients), Intermediate Onset Bipolar Disorder (IOBD; AAO=22-34 years; 59 patients) and Late Onset Bipolar Disorder (LOBD; AAO ≥35 years; 36 patients). The subgroups were compared on clinical variables, items of the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Scale for Assessment of Positive Symptoms (SAPS) scales and family history of illness. Results: The EOBD subgroup had significantly more episodes per year (p-value <0.001 and partial eta squared value=0.17) than IOBD and LOBD subgroups (mean episodes per year, respectively in EOBD, IOBD and LOBD were 1.8, 0.8 and 0.6). The prevalence of family history of mood disorder was also significantly higher in the EOBD (present in 35 out of 67; χ2 value=22.8 and p-value <0.001) than both the other subgroups (present in 10 out of 59 in IOBD and 6 out of 36 in LOBD). Significant differences were found on different items of YMRS, HAM-D and SAPS scales among the subgroups EOBD subgroup had higher rating on irritability, motor activity energy, sexual interest, depressed mood, delusions, thought disorders, while LOBD subgroup had higher rating on elevated mood. Conclusion: EOBD subgroup can be considered as a specific phenotype of BD patients, which is more homogenous, severe and heritable form of illness.

scholarly journals Clinical Features of Cluster Headache: A Hospital-Based Study in Taiwan

2021 ◽  
Vol 12 ◽  
Author(s):  
Chien-An Ko ◽  
Guan-Yu Lin ◽  
Chi-Hsin Ting ◽  
Yueh-Feng Sung ◽  
Jiunn-Tay Lee ◽  
...  
Keyword(s):  
Family History ◽  
Cluster Headache ◽  
Tertiary Care ◽  
Time Lag ◽  
Age At Onset ◽  
Positive Family History ◽  
Care Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical College

Most previous studies on cluster headache (CH) focus on Western populations. This study aimed to investigate the clinical characteristics of CH in a neurology outpatient population in Taiwan. A cross-sectional survey was conducted from July 2015 to June 2019 in a medical college affiliated with a tertiary care hospital (Tri-Service General Hospital) in Taiwan. All consecutive patients reporting headache as their chief complaint were asked to participate in a face-to-face interview with a qualified headache specialist and to complete a detailed self-administered questionnaire. The diagnosis of CH was made according to the Third edition of the International Classification of Headache Disorders. The subjects comprised 80 consecutive new CH patients (13 women and 67 men; ratio, 1:5). The mean age at presentation was 36.0 ± 10.8 years (range, 16–64 years), mean age at onset was 27.2 ± 12.1 years (range, 5–65 years), and mean time lag before diagnosis was 9.3 ± 10.5 years (range, 0–46.4 years). Of the total CH patients, 25.3% reported feelings of restlessness during headache episodes. A seasonal predilection was reported by 18% of the CH patients. The use of tobacco was the most common (44/80 patients). Chronic CH was only observed in 5% of the patients and only one patient (1.3%) reported both a positive family history for CH and aura. Features of CH in Taiwanese patients differed from that of Caucasian patients; a lower prevalence of chronic CH, positive family history of CH, and occurrence of aura may be less common in the former than in the latter.

Study of vitiligo at a tertiary care hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 112-114
Author(s):  
P Ravindra Kumar ◽  
Keyword(s):  
Family History ◽  
Tertiary Care Hospital ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Age At Onset ◽  
Positive Family History ◽  
Care Hospital ◽  
Morphological Pattern ◽  
Hla Antigen ◽  
Triggering Factor

Background: Vitiligo is a common acquired, progressive, multifactorial, depigmenting disorder characterized by the appearance of circumscribed white macules varying patterns, varying from small macules with scalloping borders to near total depigmentation of body, supposed to be due to chronic, progressive loss of functional melanocytes in the epidermis. This study was aimed to study vitiligo in our tertiary care hospital. Material and Methods: This prospective, observational and descriptive study was conducted in OPD patients clinically diagnosed as vitiligo during study period. Results: A total of 300 patients were included in the study after applying inclusion and exclusion criteria. Among these 179 (59.67%) were females and 121 (40.33%) were males. The female to male ratio was 1.5:1. The age at onset was found to be in the 11-20 age group in 104 (34.5%) patients. Most common duration was noted as between 1 to 5 years, 169 (56.5%) patients. A positive family history was present in 62 (20.5 %) patients In 67 patients triggering factor was noted. Koebner’s phenomenon was noted in 62 (22.2%) patients while leucotrichia was seen in 33 (11 %) patients in our study. Most common site affected was lower limb in 204 patients (68.17%), followed by upper limb in 194 (64.67%) patients. Clinically most common morphological pattern was vitiligo vulgaris noted in 52.5% patients. Acrofacial, segmental, universal, mucosal patterns were noted in 23.83 %, 7.67 %, 5.67 %, 1 % patients respectively. Conclusion: Vitiligo has a multifactorial origin, unpredictable triggers and progress of disease. Early age of onset, family history, HLA antigen, presence of leucotrichia, other skin problems are predictors for poor prognosis.

Obesity and Obstetric Complications are Associated with Rapid-cycling in Italian Patients with Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S74-S74
Author(s):  
A. Caldiroli ◽  
M. Buoli ◽  
B. Dell’Osso ◽  
G.S. Carnevali ◽  
M. Serati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Antidepressant Treatment ◽  
Age At Onset ◽  
Obstetric Complications ◽  
Psychotic Symptoms ◽  
Rapid Cycling ◽  
Clinical Variables ◽  
History Of ◽  
Bipolar Patients

IntroductionRapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous results about clinical variables potentially associated with RCBD were discordant or unreplicated.ObjectivesAn early diagnosis should be the goal to properly treat RCBD patients.AimsTo compare clinical variables between RC and non-RC bipolar patients and to identify related risk factors.MethodsA sample of 238 bipolar patients was enrolled from three different community mental health centers. Descriptive analyses were performed on total sample and patients were compared in terms of sociodemographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios.ResultsOverall, 28 patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (P < 0.05), obesity (P < 0.05) and a trend to hypercholesterolemia (P = 0.08). In addition, RC bipolar patients presented more frequently lifetime MDMA misuse (P < 0.05) than patients without RC.ConclusionsObesity and obstetric complications are risk factors for the development of RC in BD. Lifetime MDMA misuse may be more frequent in RC bipolar patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

MELASMA: A HOSPITAL BASED RETROSPECTIVE STUDY ON CLINICOEPIDEMIOLOGICAL PROFILE

2021 ◽  
pp. 23-25
Author(s):  
Tanya Pandey ◽  
Pranjal Ahire ◽  
Shylaja Someshwar
Keyword(s):  
Retrospective Study ◽  
Family History ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age At Onset ◽  
Sun Exposure ◽  
Care Hospital ◽  
Exposed Skin ◽  
Female Predominance ◽  
Using Data

Background: Melasma is a common, therapeutically challenging, psychological distressing, pigmentary disorder of sun exposed skin. Aim Of The Study: To study the clinical and epidemiological prole of melasma patients. Materials And Methods: Tertiary care hospital retrospective study using data of melasma patients who attended the dermatology outpatient clinic between February 2012 to May 2021. Study included 296 patients above 18 years. Demographic details were obtained from the pigment clinic proforma. Results: Mean age of 296 patients was 35.4 years, with female predominance (86.1%). Mean age at onset of melasma was 31.9 years. Aggravation with sun exposure was noted in 64.2% cases. Family history was present in 15.2% cases while hypothyroidism in 3.4% cases. Malar involvement was commonest (68.6%). Under Wood's lamp, epidermal type was commonest (57.4%). Cosmetic usage was present in 6.4% cases. Pregnancy precipitation and pregnancy aggravation was noted in 16.5% and 9% females. 7.5% females reported OC pill usage. Conclusion:This study showcases the multifaceted prole of patients aficted with melasma in a tertiary care hospital.

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

Epidemiology and clinical outcome of ventilator-associated events at a tertiary care hospital from North India

2020 ◽  
pp. 004947552098245
Author(s):  
Pooja Kumari ◽  
Priya Datta ◽  
Satinder Gombar ◽  
Deepak Sharma ◽  
Jagdish Chander
Keyword(s):  
Mechanical Ventilation ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Control Measures ◽  
North India ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Utilisation Rate

The aim of our study was to determine the incidence, microbiological profile, risk factors and outcomes of patients diagnosed with ventilator-associated events in our tertiary care hospital. In this prospective study, intensive care patients put on mechanical ventilation for >48 h were enrolled and monitored daily for ventilator-associated event according to Disease Centre Control guidelines. A ventilator-associated event developed in 33/250 (13.2%); its incidence was 3.5/100 mechanical ventilation days. The device utilisation rate was 0.86, 36.4% of patients had early and 63.6% late-onset ventilator-associated pneumonia whose most common causative pathogen was Acinetobacter sp. (63.6%). Various factors were significantly associated with a ventilator-associated event: male gender, COPD, smoking, >2 underlying diseases, chronic kidney disease and elevated acute physiological and chronic health evaluation II scores. Therefore, stringent implementation of infection control measures is necessary to control ventilator-associated pneumonia in critical care units.

scholarly journals Genome-wide association analysis of age at onset and psychotic symptoms in bipolar disorder

2011 ◽  
Vol 156 (3) ◽  
pp. 370-378 ◽  
Author(s):  
Pamela Belmonte Mahon ◽  
Mehdi Pirooznia ◽  
Fernando S. Goes ◽  
Fayaz Seifuddin ◽  
Jo Steele ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Association Analysis ◽  
Age At Onset ◽  
Genome Wide Association ◽  
Psychotic Symptoms ◽  
Genome Wide Association Analysis ◽  
Genome Wide

Distribution of age, gender and body weight in AMI patients in a tertiary care center of Eastern India

2021 ◽  
Vol 12 (6) ◽  
pp. 75-58
Author(s):  
Tanushri Khatua ◽  
Tanima Mandal ◽  
Mita Saha ◽  
Biswajit Majumder
Keyword(s):  
Body Weight ◽  
Family History ◽  
Care Center ◽  
Tertiary Care ◽  
Positive Family History ◽  
Premenopausal Women ◽  
Care Hospital ◽  
Risk Of Mortality ◽  
And Gender ◽  
Risk Predictors

Background: The leading cause of death in the world is coronary heart disease (CHD). In India, CHD manifests almost a decade earlier than in Western countries. Gender differences play an important role in the pathophysiology of AMI. Body weight and family history are claimed to be the indicators of relative risk of mortality. Aims and Objective: To look for the age and gender distribution pattern in patients with recent diagnosed AMI and to find out the association of some of the risk factors like BMI, family history. Materials and Methods: A descriptive study was conducted in a tertiary care hospital with 50 recent diagnosed AMI patients of either sex as cases after considering the inclusion and exclusion criteria. The biochemical parameters were measured by validated methods. Results: On statistical analysis, 58% of total AMI cases occurred before 50 years of age; out of which 18% belong to 31 - 40 years, 40% belong to 41- 50 years. Out of total 50 AMI cases, 60% is male and 40% is female. Obesity seen in 14% cases and 56% is overweight; 16% having positive family history. Conclusion: The study indicates a trend of early age onset AMI. Increased body weight and positive family history can be the risk predictors. It is suggested that younger age males and premenopausal women should not be ignored regarding the risk of MI. Further studies are required for verification.

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