scholarly journals Psychiatric Morbidity in Elderly Patients attending OPD of Lumbini Medical College and Teaching Hospital

2021 ◽  
Vol 9 (02) ◽  
pp. 36-40
Author(s):  
Bhaskkar Sharma ◽  
Rajesh Shrestha

INTRODUCTION: Geriatric psychiatry patients are increasing but enough work has not been done in this area of Nepal. We conducted this study to find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. MATERIAL AND METHODS: Medical records of psychiatric patients above 65 years of age visiting outpatient department of Lumbini Medical College and Teaching Hospitalfrom April 1, 2018 to March 31, 2019 were reviewed. Risks of having different psychiatric disorders was estimated using odds ratio. RESULTS: A total of 300 cases were enrolled in the study. Mean age of the study group was 71.49(SD=6.99). There were more females. Depressive disorderwas the most common diagnosis followed by somatoform disorder, anxiety disorder, dementia and others. Depressive disorder was higher in females and in younger subgroup of the elderly patient.The risk of having dementia was higher in older group. CONCLUSION: Depressive disorder was the most common psychiatric disorderfollowed by somatoform disorder in elderly patients above 65 years of age. Male patients were more likely to suffer psychiatric disorder as compared to females in this age.

2021 ◽  
Author(s):  
Weiqi Ke ◽  
Yuting WANG ◽  
Xukeng GUO ◽  
Ronghua HUANG ◽  
Xiangdong ZHANG ◽  
...  

Abstract Background:Artificial femoral head replacement is one of the most effective methods for treatment of severe diseases of femoral joint in the elderly. The ideal anesthetic effect is one of the key elements for the success of the operation because it brings fast recovery. However, the multiple comorbidities of the elder patients make them too weak to tolerate the hemodynamic changes after anesthesia. In this case, the most suitable anesthesia method for patients undergoing femoral head replacement surgery is of great significance.Objective:To compare the post-anesthetic hemodynamic changes between combined lumbar plexus and sciatic nerve block(CLPSB) and combined spinal and epidural anesthesia(CSEA) in elderly patients undergoing unilateral artificial femoral head replacement.Methods:We reviewed records of the patients who aged over 60 years old (age 62-103 years) and received unilateral artificial femoral head replacement between January 2015 and December 2020 in the first affiliated hospital of Shantou University Medical College. After adjustment according to the inclusion criteria, 477 patients were included and divided into CLPSB group (n=90) and CSEA group (n=387). The primary outcome was comparison of the hemodynamic changes after anesthesia, including the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). The second outcome was the comparison of the vasopressor used during the surgery.Results:We established three models to compare the two anesthesia methods on hemodynamic changes. Crude model included all variates for analysis, while model I adjusted age and gender. Model II adjusted other comorbidities in addition to model I. All three models exhibit that changes of MAP (∆MAP) after CSEA were higher than that after CLPSB(β= 6.88, 95% CI: 4.33 - 9.42, P < 0.0001), with significant difference, which indicated that CSEA causes higher fluctuation of MAP. Concurrently, the use of vasopressors increased by 137% (OR=2.37, 95%CI: 1.24-4.53, P=0.0091) in the CSEA group, which is statistically significant. However, the changes of HR (∆HR) between the CLPSB and CSEA was not significant(β= 0.50, 95% CI: 1.62 - 2.62, P = 0.6427). Conclusions:Both CLPSB and CSEA are ideal anesthesia methods for patients receiving femoral head eplacement, though CLPSB is more suitable for elderly patients with advanced hemodynamic stability.


2011 ◽  
Vol 26 (S2) ◽  
pp. 834-834 ◽  
Author(s):  
L. Prats ◽  
N. Gual ◽  
P. Lusilla ◽  
A. Gual

IntroductionThere is no general agreement on the prevalence of mental disorders in the elderly, although it is estimated that 25%. of them present psychiatric symptoms. Geriatric psychiatry is one of the most rapidly advancing fields and requires a comprehensive approach.ObjectivesTo analyse the characteristics of patients older than 65 who are attended at the psychiatry emergency room.MethodsA descriptive study was conducted among all elderly pacients seen during May 2010 at the psychiatry emergency room at Vall d’Hebron University Hospital. Clinical variables (functional status, reason to show up, medical history, diagnosis), treatment and referral at discharge were analysed.Results36 patients (44.4% men, mean age 75.3 years) were identified. Charlson comorbidity index was 2.08. Suicide attempts were the most frequent reason for admission (27.8%), followed by psychomotor agitation (16.7%), anxiety disorders (13.9%), delirium (13.9%), depression (11.1%), and behaviour disorders (8.3%). Concerning psychiatric antecedents 58.3% had depressive disorder and 40% reported somatic symptoms during the month prior to their consultation.The most common diagnosis at discharge were anxiety-depressive disorders (52.7%) and delirium (16.7%). The most widely prescribed psychotropics were antipsychotics (19.4% haloperidol, 13.9% quetiapine) followed by benzodiazepines (13.9%). Referral at discharge was: 41.7% home, 13.9% midterm psychiatric units, 27.8% acute psychiatric inpatient unit and 16.7% Internal Medicine.ConclusionsTypically, elderly patients attended at the psychiatric emergency room are diagnosed of an anxiety-depressive disorder and often present with a suicidal attempt, but only 41.7% are admitted as psychiatric inpatients.


2011 ◽  
Vol 18 (04) ◽  
pp. 615-620
Author(s):  
MUHAMMAD RAZZAQ MALIK ◽  
MUHAMMAD AZEEM ◽  
MUHAMMAD ZAFAR IQBAL

Background: Pakistan is experiencing a rise in its elderly population leading to increase burden of orthopedic injuries. With meager resources and a poor understanding of elderly health problems; Pakistan faces many challenges in caring for its elderly population. Objectives: The objectives of this study were to, “Assess the frequency of orthopedic injuries among elderly persons and the associated risk factors at Sheikh Zayed Medical College/ Hospital Rahim Yar Khan”. Study design and duration: This was an analytical observational study conducted among the elderly patients above the age of 60 years, admitted in the Orthopedic Department of Sheikh Zayed Medical College/ Hospital Rahim Yar Khan. Methodology: The data was collected regarding the frequency, causes and pattern of orthopedic injuries in elderly patients admitted in the Orthopedic Department of Sheikh Zayed Hospital / Medical College Rahim Yar Khan. The data regarding age, sex, education, occupation, geographical origin, and mechanism of injury were obtained by questionnaire. The data was analyzed on SPSS version 16. Results: There were total 1589 patients admitted in the Orthopedic Unit during the study period. The elderly persons above the age of 60 years were 291(18.31%). There were 184(63.24%) males and 107(36.76%) females. The average age was 64.52 years in urban residents and 66.34 years in rural residents’ patients. Among the frequency of injuries, the femoral neck and inter-trochanter region were most commonly involved. The proportion of injuries in males it was 44.02% and in females it was higher that was 49.53%. The majority (68.29%) of the elderly persons was dependent and was not satisfied with socio-economic condition and status in the family (p < 0.000). Conclusions: Elderly patients who have experienced trauma are at increased risk of subsequent injury. Interventions to reduce the likelihood of trauma recurrence should focus on those with chronic illnesses and functional impairments.


2018 ◽  
Vol 45 (1-3) ◽  
pp. 213-217
Author(s):  
Zdenka Hruskova ◽  
Vladimir Tesar

Background: Rapidly progressive glomerulonephritis (RPGN) is characterized by a rapid deterioration of renal function and by extracapillary proliferation in >50% of glomeruli. The most common type of RPGN is “pauci-immune” glomerulonephritis caused by anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV). Summary: The incidence of AAV increases with age and pauci-immune glomerulonephritis is the most common diagnosis found in renal biopsies in the elderly population. Age was identified as an independent negative risk factor for both death and end-stage renal disease in AAV, and the mortality of older patients was uniformly higher than in younger patients in all retrospective studies. Early diagnosis may be difficult particularly in elderly patients with renal-limited disease but is important for the good outcome of the patients. Immunosuppressive treatment options include cyclophosphamide or rituximab combined with corticosteroids with or without plasma exchange in case of severe disease. Data from randomized trials are completely missing for patient aged >75 years. Based on retrospective studies, elderly patients seem to respond to immunosuppressive drugs just as younger patients are able to, but they are at a higher risk of adverse events. Key Messages: RPGN is relatively common in the elderly patients. Immunosuppressive treatment in older patients with AAV or RPGN may be useful but needs to be strictly individualized with all the risks taken into consideration. Further studies are needed to examine the role of novel therapeutic options in the elderly population with RPGN.


2013 ◽  
Vol 26 (1) ◽  
pp. 39-48 ◽  
Author(s):  
D. P. Devanand

ABSTRACTThe diagnosis of dysthymic disorder was created in DSM-III and maintained in DSM-IV to describe a depressive syndrome of mild to moderate severity of at least two years’ duration that did not meet criteria for major depressive disorder. The prevalence of dysthymic disorder is approximately 2% in the elderly population where subsyndromal depressions of lesser severity are more common. Dysthymic disorder was replaced in DSM-V by the diagnosis of “persistent depressive disorder” that includes chronic major depression and dysthymic disorder. In older adults, epidemiological and clinical evidence supports the use of the term “dysthymic disorder.” In contrast to young adults with dysthymic disorder, older adults with dysthymic disorder commonly present with late age of onset, without major depression and other psychiatric disorders, and with a low rate of family history of mood disorders. They often have stressors such as loss of social support and bereavement, and some have cerebrovascular or neurodegenerative pathology. A minority has chronic depression dating from youth with psychiatric comorbidity similar to young adults with dysthymic disorder. In older adults, both dysthymic disorder and subsyndromal depression increase disability and lead to poor medical outcomes. Elderly patients with dysthymic disorder are seen mainly in primary care where identification and treatment are often inadequate. Treatment with antidepressant medication shows marginal superiority over placebo in controlled trials, and problem-solving therapy shows similar efficacy. Combined treatment and collaborative care models show slightly better results, but cost effectiveness is a concern. Further work is needed to clarify optimal approaches to the treatment of dysthymic disorder in elderly patients.


2020 ◽  
Vol 32 (1) ◽  
pp. 52-54
Author(s):  
Md Shafiul Islam ◽  
Aminur Rahman ◽  
Siddhartha Paul

Introduction: Mental health problem is a major public health issue in the world across the developed and developing countries. However, data in most of the developing countries including Bangladesh are scarce. In Bangladesh, socio-political situation is insecure and unstable with poverty and vulnerable to natural disaster which causes psychiatric morbidity. The pattern of psychiatric morbidity attended in OPD is quite different from that in government hospital. This study was aimed to assess the diagnostic pattern of psychiatric morbidity among the attended patients in a out patient department in a medical college. Materials and Methods: The study was carried out in a OPD which is situated in 500 bedded private medical college in the sylhet city. All the information including longitudinal histories of patients was recorded in files and the diagnosis was confirmed by psychiatrist. All information notes were recorded in register. Socio -demographic parameters and family history of mental illness were collected from the record file of individual patient. Results: Among 304 patients 184 (60.53%) were males and 120 (36.47%) were females. More than 50% of patients were in the age group of 18 to 37 years. Most common psychiatric disorders were schizophrenia and other psychotic disorders (39.4%), mood disorder (18.75%), borderline personality disorder (3.6%), conduct disorder (2.3), somatoform disorder (1.6%), anxiety disorder (0.7%), organic psychiatric disorder (2%), impulse control disorder (1.3%) and adjustment disorder (0.7%). Conclusion: Major forms of psychiatric disorders are common both in urban and rural areas of Bangladesh. Medicine Today 2020 Vol.32(1): 52-54


2007 ◽  
Vol 19 (4) ◽  
pp. 691-704 ◽  
Author(s):  
Noeline Nakasujja ◽  
Seggane Musisi ◽  
James Walugembe ◽  
Daphne Wallace

Background: The elderly are vulnerable to illness and particularly to psychiatric illness. Many mentally ill elderly patients end up on non-psychiatric wards owing to somatization of their illnesses. Even for these patients, a psychiatric diagnosis may not be made. The literature on the elderly in Uganda is very scanty. This study aims to establish the prevalence and factors associated with psychiatric disorders among elderly patients admitted to non-psychiatric wards.Methods: We carried out a descriptive cross-sectional study of 127 consenting elderly patients. They were administered a standardized questionnaire comprising the Self Reporting Questionnaire 25, the Mini-mental State Examination and the Structured Clinical Interview for the Diagnostic and Statistical Manual IV. Study variables included socio-demographic characteristics, physical illnesses, psychiatric disorders and the treatment given.Results: The rate of psychiatric morbidity was 48%. The sex ratio was 1:1; however, women had a higher rate of psychiatric illness than men, 54.6% and 41.3% respectively. Being widowed or separated and having cancer were associated with SRQ > 5, p = 0.02 and p = 0.04 respectively. Depressive disorders were the most common at 25.2% and were more common in women. Increasing age was associated with dementia (p < 0.00).Conclusion: There is a high rate of psychiatric morbidity among the elderly in Uganda. Particular attention should be given to the psychological health of elderly people admitted to general hospitals.


Author(s):  
Sakib Arfee ◽  
Asma Jabeen ◽  
Akib Arfee ◽  
Adnan Aadil Arfee

Background: Fractures in the neck and Perirtrochanteric region of hip contribute significantly to health problem globally. Primary occurrence in elderly osteoporotic people and create a major socioeconomical and public health problem. Almost every such fractures require surgery, hospitalization, and prolonged rehabilitation. The objective of the study was to evaluate the risk factors of hip fractures among the elderly population.Methods: This observational study was conducted among the elderly patients admitted in the department of orthopedics Government Medical College Jammu. Elderly patients regardless of sex and education admitted with hip fractures from August 2019 to July 2020 were included in the study.Results: There were 330 patients admitted with hip injuries. Among these 330 patients admitted with hip fractures, 205 (62.12%) were females and 125 (37.88%) males, mean age was 72.8 years. Age limit was >60 and <100 years. Majority of the patients i.e., 192 (58.18%) were in between the age group of 60 to 79 years.Conclusions: Increasing age is directly proportional to increasing incidence of hip fractures. This proportional rise can be reduced with early steps for prevention of osteoporosis and hence ultimately alleviate the disability and burden of the disease.


2018 ◽  
Vol 35 (01) ◽  
pp. 009-016 ◽  
Author(s):  
Kristofer Schramm ◽  
Paul Rochon

AbstractIn the past 20 years, peripheral artery disease (PAD) has been increasingly recognized as a significant cause of morbidity and mortality in the United States. PAD has traditionally been identified as a male-dominant disease; however, recent population trends and studies in PAD suggest that women are affected at least as often as men. Women comprise a larger population of the elderly than men, as well as an increasing proportion of patients with PAD. Much of the existing research on PAD has focused on whole populations, and gender-specific data on PAD is sparse. This review focuses on gender-specific differences in presentation, management, and outcomes of PAD intervention that are important considerations for the interventional radiologist.


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