scholarly journals Study of Pathway to Care among Patients with Epilepsy

2013 ◽  
Vol 1 (1) ◽  
pp. 20-25 ◽  
Author(s):  
S Subedi ◽  
PM Shyangwa ◽  
R Shakya ◽  
AK Pandey
Keyword(s):  
Tertiary Care ◽  
Complex Partial Seizure ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Generalized Seizures ◽  
The Mean ◽  
Patients With Epilepsy ◽  
First Contact ◽  
Pathway To Care

Objective: To assess the pathway to care among patients with epilepsy up to the tertiary care centre Methods: It is a hospital based, cross-sectional descriptive study of 47 patients visiting BPKIHS psychiatry OPD. Written informed consent was taken from the patients and the primary caretaker. A semi structured Performa was used to record the basic sociodemographic details. Pathway Interview Schedule developed by WHO was used to collect the data. Results Majority (66.0%) of subjects were male. Generalized Seizures were most common (76.6%) type of seizure followed by complex-partial seizure (10.6%). More than half (51.1%) first contacted dhami-jhakri for treatment of their illness. About sixty two percent of patients had the first contact with the treatment provider less than 4 yrs ago. Thirty eight percent subjects sought treatment as per advice from the family members while only 2.1% sought treatment as per advice from the healthcare worker. The most common presenting complaints were sudden loss of consciousness in 89.4%of patients. In majority of patients (57.4%), problem arised ≤ 4yrs back. Significant high numbers of patients (51.1%) were prescribed alternative forms of treatment like herbal medications, talisman, offerings and sacrifices and jhadphook for their presenting problem. About eighty seven percent patients had to travel ≤12 hours for the treatment while 10.7% had to travel a distance of >24 hrs for treatment. The mean duration that one had to travel for seeking treatment was 7.95±14.58 hours. It was found that the mean duration that one patient spend before coming to a hospital for modern treatment was 5.64 months. Conclusions People suffering from epilepsy are still using the traditional healing practices leading to delay in the patient care. These findings call for a comprehensive educational program that can remove the misconcepts regarding the illness. DOI: http://dx.doi.org/10.3126/jucms.v1i1.8418   Journal of Universal College of Medical Sciences Vol.1(1) 2013:  20-25

Magnitude of thyroid dysfunction among antenatal women attending tertiary care centre

2019 ◽  
Vol 8 (11) ◽  
pp. 4371
Author(s):  
Deepa Shanmugham ◽  
Deepak Kannan Saravanan ◽  
Priyanka Shah
Keyword(s):  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
First Trimester ◽  
Endocrine Disorders ◽  
Tertiary Care Centre ◽  
Free T4 ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Mean

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.

scholarly journals Position of parotid papilla and commissure of lip in relation to maxillary occlusal plane among patients visiting a tertiary care centre of Nepal

2021 ◽  
Vol 4 (1) ◽  
pp. 1-6
Author(s):  
P Mehta ◽  
S Chhetri
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Occlusal Plane ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Exact Position ◽  
The Mean ◽  
Edentulous Patients

Introduction: The exact position of the Parotid papilla and commissure of the lip plays a crucial role in determining the maxillary occlusal plane which directly facilitates rehabilitating edentulous patients with a removable complete denture. Since the beginning, many authors have conducted different studies regarding its position but multiple variations in its location have been noted. Also, this type of study has not been conducted in the Nepalese population which drags the urge to determine the position of these soft-tissue landmarks in context to the Nepalese population. Objective: To determine the position of parotid papilla and commissure of lip in relation to the maxillary occlusal plane. Materials and Methods: A descriptive cross-sectional study was conducted in the 45 dentate subjects visiting Nobel medical college from November 2019 to April 2020. A vestibular impression was made, stone index fabricated and vernier caliper was used to locate position of parotid papilla & commissure of lip. All the data were collected and statistically analyzed. Results: The mean measurement of distances between maxillary occlusal plane and parotid papilla was 3.69 ± 1.19 mm and between maxillary occlusal plane and commissure of lip was 0.41 ± 0.83 mm respectively. Conclusion: This study showed that the position of the parotid papilla was superior to the position of the maxillary occlusal plane with a mean distance of 3.69mm. The commissure of lip was found to be at the level of maxillary occlusion plane in highest number of cases followed by a superior position with least at the inferior position with respect to the maxillary occlusal plane.

scholarly journals Cross-sectional descriptive observational study of RT PCR proven category C H1N1 patients at tertiary care centre from January 2015- December 2015

2017 ◽  
Vol 5 (8) ◽  
pp. 3458
Author(s):  
Anita A. Paritekar ◽  
Mahendra V. Bansode ◽  
Anushka K. Waikar ◽  
Rohidas T. Borse
Keyword(s):  
Influenza A ◽  
Tertiary Care ◽  
Age Group ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Hospital Records ◽  
Influenza A H1n1 ◽  
The Mean ◽  
Death Cases

Background: The onset of winter of 2014-2015 saw an alarming spurt in influenza A (H1N1) pdm 09 leading to a significant mortality. H1N1 primarily affects the very young, elderly, pregnancy and those patients with comorbidities. But the epidemiologic hallmark of pandemic influenza is its "pandemic signature " meaning most early mortalities are among young healthy adults.Methods: To study clinical profile, premorbid conditions and radiological features of Category C H1N1 proven by RTPCR retrospectively from hospital records from Jan 2015 to Dec 2015 at Tertiary Care Centre.Results: Total 108 cases RT PCR proven category C H1N1 studied from hospital records. 43 were males and 65 females. The mean age group was 50 years for males and 40 for females. Common symptoms were fever, cough, dyspnoea with pre-morbid illness like hypertension, diabetes mellitus, pregnancy, cancer and immune compromised with pulmonary tuberculosis. Radiologically there was lower zone involvement common in live patients and reticulonodular was common in death cases.Conclusions: In current study young to middle age group was commonly affected. Pre-morbid conditions, more than two risk factors and late referral were the most common findings in death cases.

scholarly journals Prevalence of Hamstring Tightness in Young Orthopaedic Surgeons

2021 ◽  
Author(s):  
Atul Sareen ◽  
Jatin Prakash ◽  
. Vikas
Keyword(s):  
Back Pain ◽  
Tertiary Care ◽  
Knee Extension ◽  
Lower Limbs ◽  
Low Back ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Orthopaedic Surgeons ◽  
The Mean ◽  
Very High

Introduction: Hamstring is a group of muscles that form an important part of core muscles (lumbo-pelvic and hip complex) and their tightness may reduce the lumbar lordosis thereby potentially decreasing the absorption of force, affecting posture, range of motion of lower limbs and increasing the possibility of developing Low Back Pain (LBP). It was planned to test hamstring tightness in group of Orthopaedic Surgeons as this group has been shown to be prone to develop back pain. Aim: To find prevalence of hamstring tightness in young Orthopaedic Surgeons who do not suffer from back pain. Materials and Methods: This was a cross-sectional observational study conducted at a tertiary care centre. Eighty two Orthopaedic Surgeons, between ages 24-35 years, were enrolled in the study. The height and weight of the subjects were recorded using a standardised medical scale. Age and medical history were recorded using a questionnaire. Knee extension angle were measured by active knee extension test. Less than 20 degree was considered normal. A 21-30 degree was regarded as mild tightness, 31-40 degree as moderate tightness and >40 degree as severe tightness. Results: Eleven surgeons (12.9%) did not have any hamstring tightness on either side. Rest all had some degree of hamstring tightness. There was no side predominance for hamstring tightness and both sides were equally involved (p=0.67). The mean tightness on right side was 30.83 degree and left side was 31.11 degree. Further, there was no relation of Body Mass Index (BMI) and hamstring tightness. Conclusion: Prevalence of hamstring tightness is very high among young Orthopaedic Surgeons.

scholarly journals Duration of untreated psychiatric illness and its correlations in patients attending a tertiary care psychiatric facility: a cross-sectional study

2013 ◽  
Author(s):  
Swarna Buddha Nayok ◽  
Sathyanarayana MT ◽  
Dhanashree Akshatha H.S.
Keyword(s):  
Psychiatric Illness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Psychiatric Facility ◽  
Cross Sectional ◽  
Duration Of Untreated Illness ◽  
Duration Of Illness ◽  
The Mean ◽  
Pathway To Care

Introduction: Duration of untreated psychiatric illness is an important component of the final pathway to care for patients. Longer the duration of untreated illness, poorer is the prognosis. Aim: To determine the Duration of Untreated Illness (DUI) along with its correlates, to thus evaluate the pathway to care at our setup. Settings and design: A retrospective cross-sectional study including 228 patients with psychiatric illnesses done at a tertiary care general hospital with a psychiatric setup. Materials: Semi-structured proforma for socio-demographic details, psychiatric diagnosis, duration of illness and duration of untreated illness. Statistical analysis: Sociodemographic details were mainly descriptive and categories compared using Pearson’s Chi square test. Results: The mean age of patients was 36.13 years (Standard Deviation (S.D.) 15.06). The mean DUI was 57.53 months (80.21). Excluding patients with Alcohol Dependence Syndrome (ADS), mean duration of illness was 51.58 months (S.D. 75.50) and DUI was 33.77 months (S.D. 49.11). Mean duration of illness for ADS group was 176.19 months (S.D. 101.20) and DUI was 165.90 months (S.D. 103.07). There was significant association of DUI with occupation (P = .039) and residence (P = .006). While 127 (55.70%) of patients showed to a psychiatrist at first, seventy (30.7%) patients went to faith healers first. Conclusion: It took about 5 years on average to reach a psychiatric facility, which was higher in patients with ADS. Awareness regarding illness model of ADS and other psychiatric disorders along treatment availability may improve DUI and lead to better prognosis.

scholarly journals Antibiotic utilization pattern in the department of surgery in a tertiary care centre in eastern India

2019 ◽  
Vol 6 (11) ◽  
pp. 4080
Author(s):  
Archana Dipa Sangita Kujur ◽  
Nishith M. Paul Ekka ◽  
Satish Chandra
Keyword(s):  
Bacterial Resistance ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Study Data ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Prevalence Survey ◽  
Cross Sectional

Background: The overuse and volume of antibiotic prescription has been found to correlate to the incidence of bacterial resistance. Clinical audit and education can favourably change antibiotic prescribing patterns among practitioners.Methods: Prospective cross-sectional prevalence survey carried out in inpatient department (IPD) and outpatient department (OPD) of department of Surgery, Rajendra Institute of Medical Sciences, Ranchi. 200 prescriptions from OPD and 200 case sheets from IPD were randomly selected. Data was analyzed as per WHO outpatient prescribing indicators. ICU patients and patients on anti-tubercular treatment, antifungals etc. were excluded from this study. Data were computed and analyzed using MS Excel.Results: In the OPD, the average no of drugs per patient was 3.445 of which 17% were injections. 33% of drugs prescribed were antibiotics. Beta-lactams followed by nitroimidazoles were the most common antibiotic class. In the IPD, an average of 2.26 antibiotics per patients was prescribed. 21% of antibiotics were prescribed by a generic name and 196 patients received antibiotic prophylaxis. β-lactams again were the most commonly prescribed antibiotic class with 42.7% (n=193) of total antibiotics prescriptions, Metronidazole (n=101, 22.37%) was the most prescribed antimicrobial agent.Conclusions: The practice of polypharmacy and high antibiotic prescription rate is a concern in our part of the country. Prescriptions writing in generic name needs to be encouraged. There is an acute need for the development of antibiotics prescribing guidelines in India.

scholarly journals Clinical profile of diabetes in young adults aged 15 to 30 years

2019 ◽  
Vol 6 (5) ◽  
pp. 1466
Author(s):  
Jimnaz P. A. ◽  
Nishad N. ◽  
Harris P.
Keyword(s):  
Age Of Onset ◽  
Total Cholesterol Level ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Positive Family History ◽  
Clinical Profile ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
The Mean

Background: There is a shift in age of onset of diabetes to a younger age in the recent years. There are very few data available on diabetes in the youth. Hence the study has been undertaken. Objective of the study is to describe the clinical profile of young diabetics and to estimate burden of selected end organ complications at the time of study.Methods: A hospital based Cross sectional study was conducted at a tertiary care centre among 75 young diabetic patients (aged 15-30 years). After taking informed consent, detailed history clinical examination, biochemical investigations like FBS and 2 hours PPBS, HbA1c, lipid profile, screening for neuropathy, retinopathy and nephropathy were done.Results: The mean age of the study population was 26.35±3.8 years, majority were males (62.7 %), 77.3% have positive family history. Mean BMI was 24.8±4.6 kg/m2, 45.3% were overweight ,20 % were obese. The mean FBS levels was 216.63±73.46 mg/dl, 2 hr PPBS 261.51±80.0 mg/dl and mean HbA1c 8.66±1.34 %. The total cholesterol level was higher in 46.7%, with mean of 198.4±21.0. Mean triglyceride level was 136.99±38.9. Nephropathy was present in 25.3%, retinopathy in 13.3% and neuropathy in 9.3 % of the patients. 30.6% had at least one of the three complications. SBP was associated with neuropathy(p=0.030), DBP with retinopathy(p=0.029) and neuropathy(p=0.007) and high FBS levels with retinopathy(p<0.001) and neuropathy(p<0.001).Conclusion: Microvascular complications in young diabetes is alarmingly high. Regular screening, early detection, adequate control of FBS and BP may improve quality of life.

scholarly journals Comparative study of intraocular pressure (IP) in Bangladeshi individuals by contact and non contact technique

2016 ◽  
Vol 8 (1) ◽  
pp. 56
Author(s):  
Sayed Abdul Wadud ◽  
Md. Sharfuddin Ahmad ◽  
Muntasir Bin Shahid
Keyword(s):  
Intraocular Pressure ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Contact Method ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Goldmann Applanation Tonometer ◽  
Applanation Tonometer ◽  
The Mean ◽  
The Difference

<p><strong>Background:</strong> Intraocular pressure (IOP) is one of the most important parameters in the diagnosis and treatment of glaucoma. Glaucoma has been established as the second leading cause of blindness. The treatment of glaucoma focuses mainly on lowering intraocular pressure (IOP). The target IOP is often set to a level 20% to 30% of IOP reduction, and consequent large IOP reduction beyond 30% or even 40% in cases of advanced glaucoma The different methods of tonometery are: Goldman Applanation tonometery, Noncontact (air-puff) tonometery, Perkins tonometery, Tonopen tonometery, Transpalpebral tonometery.</p><p><strong>Objective:</strong> To determine the frequency of accuracy of intraocular pressure (IOP) measured by non-contact (air puff) tonometer compared with Goldmann applanation tonometer.</p><p><strong>Methods:</strong> This was a non-interventional, cross sectional study conducted at a tertiary care centre of Dhaka, Bangladesh. consecutive subjects attending the BSMMU eye OPD were included in the study. IOP was measured by non-contact (air puff) tonometer and a slit lamp mounted GAT in all the subjects. The study samples were selected by convenience sampling who presented for check-up in the Eye Department of community ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka. Bangladesh. Results:A total of 120 eyes in 60 patients were studied. The mean age of the patients was 41.60 year. study population consisted of 24 (40 %) men and 36 (60 %) women. The mean intraocular pressure was 13.52 &amp;13.72 mmHg for GAT, and 16.64 &amp; 17.44 mmHg for Air puff respectively. The range of measurements by GAT was from 10 to 23 mmHg and by Air puff was 12 to 28mmHg. The difference between IOP measured by two instruments were statistically significant (p=0.000).</p><p><strong>Conclusion:</strong> Airpuff tonometer is quick, a non-contact method to measure intraocular pressure and is useful for screening purposes and postoperative case but the measurements should be confirmed with Goldmann applanation tonometer for accurate labelling of intraocular pressure.</p>

scholarly journals Complementary feeding practice in infants of 6-12 months: a study from tertiary care centre of eastern Nepal

2018 ◽  
Vol 6 (1) ◽  
pp. 156
Author(s):  
Shankar Prasad Yadav ◽  
Anita Chamlagain ◽  
Sneha Dhakal ◽  
Gauri Shankar Shah
Keyword(s):  
Parental Education ◽  
Complementary Feeding ◽  
Tertiary Care ◽  
Child Growth ◽  
Feeding Practice ◽  
Equal Proportion ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Timely Initiation ◽  
The Mean

Background: Initial years of life are crucial for child growth and development.  Breast feeding for first six months of life, followed by adequate complimentary feeding is necessary for preventing malnutrition and its complication in children. This study accessed the complementary feeding practice and the time of initiation of complementary feeding among infants.Methods: This was a cross-sectional study conducted for 3 weeks, among 92 infants. Details of feeding practice were taken from the parents from semi-structured questionnaire and nutritional status was evaluated by anthropometric assessment tools.Results: Ninety-two mothers were interviewed, and their corresponding infants were evaluated. The mean age of infant was 8.8 months with equal proportion of male and female. The mean age of mother interviewed was 26.6 yrs. 59.8% had timely initiation of complimentary feeding. Timely complimentary feeding was directly related to maternal literacy where literate mother follows the practices of appropriate complimentary feeding (p<0.007). There was significant association between ethnicity and timely initiation of complimentary feeding practices. 78.2 % babies who had timely initiation were of higher ethnicity. Overall in our cohort 18.4% were stunted, 14.1% were wasted. The stunted and wasted child were significantly more in whom there was absence of timely initiation of complimentary feeding (p<0.05).Conclusions: Proper complimentary feeding is still lagging in our society, proper parental education and nutritional counselling will be required to prevent under nutrition in infants.

scholarly journals Plastibell circumcision in neonates and infants at tertiary care centre

2018 ◽  
Vol 5 (4) ◽  
pp. 1488
Author(s):  
Nandkishor D. Shinde ◽  
Mohammad Moinuddin ◽  
A. N. M. Owais Danish
Keyword(s):  
Prospective Study ◽  
Surgical Procedure ◽  
Tertiary Care ◽  
Care Centre ◽  
Inclusion Criteria ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Surgical Time ◽  
The Mean ◽  
Neonates And Infants

Background: Circumcision is the most common surgical procedure in children worldwide. The aim of this study was to study the safety and complication of Plastibell circumcision in neonates and infants.Methods: This prospective study of 420 male children less than 1 years who underwent Plastibell circumcision for religious or cultural indication in the Department of Surgery at KBN Institute of Medical Sciences, Kalaburagi, during February 2016 to January 2018. Children were divided into two groups; neonates (0 to 4 weeks) and infants (5 weeks to1 year). Parents were given specific instructions on care of the device on discharge and followed up on day 3 and on day of separation of the Plastibell.Results: During the study period, 420 cases of Plastibell circumcision fulfilling the inclusion criteria were included and analyzed. Out of the total cases, 120 (28.57%) were neonates, whereas the remaining 300 (71.42%) were infants. Mean surgical time was 4±2 minutes. The mean number of days for Plastibell to separate was 6.2 days, Plastibell ring separation in neonates earlier (3 days to 7 days) as compared to infants (5 days to 12 days). Out of the total 420 cases 65 (15.47%) cases developed minor complications. In neonates, out of 120 cases only 05 (4.16%) developed complications. In infants, out of 300 cases, 60 (20%) developed complications.Conclusions: Neonates had shorter time for the Plastibell to separate and with fewer complications than infants. Though complications were present, they were few and could be managed easily. Plastibell circumcision is safe in neonates and infants.

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