Disability and Deformity in Patients of Hansen’s Disease Attending a Tertiary Care Center in Nepal

Introduction: Leprosy is responsible for disability and deformity among patients. Nerve damage is one of the main features of leprosy and it is the main cause of disability in the patients. Developing deformity leads to restriction in professional work and hence reduced income as well as it also acts adversely on social wellbeing. The aim of this study was to study the spectrum of Grade 2 disability among all leprosy patients attending outpatient and inpatient according to WHO grading and to find the association with Ridley Joplingclassification. Methods: It was an observational cross sectional hospital based study. All the inpatients and outpatients of leprosy getting treatment and were on follow up in the Department of Dermatology between December 2017 to November 2019 were included. Details of disability and deformity were recorded and were Classified as per WHO grading and Ridley Jopling classification. Cross tab was used in descriptive analysis to compare between different variables and data was analysed in percentage. Results: A total of 88 patients were included in the study. Maximum number of patients 41 (46.7%) belonged to 30 to 50 years of age group. Various degrees of loss of sensation was seen in all patients and total number of patients with Grade 1 disability were 68 (77.3%) and Grade 2 disability were 20 (22.7%). Maximum number of patients 11 (12.5%) with Grade 2 disability was seen in Lepromatous Leprosy. Conclusions: Disability and deformity can occur in any spectrum of disease and intervention as early as possible will help reduce the incidence.

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Metabolic syndrome in alopecia areata: an observational study at a tertiary care center

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20213338 ◽

2021 ◽

Vol 7 (5) ◽

pp. 647

Author(s):

Subrata Kumar Das ◽

Saptadipa Das

Keyword(s):

Metabolic Syndrome ◽

Observational Study ◽

Alopecia Areata ◽

Care Center ◽

Tertiary Care ◽

Age Group ◽

Tertiary Care Center ◽

Cross Sectional ◽

Laboratory Parameters ◽

Number Of Patients

Background: The aim was to evaluate the parameters of metabolic syndrome (MS) in patients of alopecia areata and to investigate the possibility of an existing relationship between MS and alopecia areata (AA).Methods: This cross-sectional observational study included 50 patients with AA who attended OPD of department of dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.Results: This study included 50 patients with AA (33 males and 17 females). In the present study maximum number of patients belonged to the age group 20-30 years with 23 patients, followed by 30-40 years with 17 patients. Most of the study subjects, 17 were college students and number of employees were 15. Out of 50 patients 44 had patch(es) and 2 patient had alopecia totalis. In this study out of 50 patients, 38 had mild AA, 7 had AA and 5 patients had severe AA. No significant derangement of clinical and laboratory parameters of MS observed in patients of AA.Conclusions: In the present study we did not observe any significant derangement of clinical and laboratory parameters of MS in patients of alopecia areata.

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Metabolic syndrome in skin tags: a hospital based observational study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20213348 ◽

2021 ◽

Vol 7 (5) ◽

pp. 708

Author(s):

Subrata Kumar Das ◽

Saptadipa Das

Keyword(s):

Metabolic Syndrome ◽

Observational Study ◽

Care Center ◽

Tertiary Care ◽

Age Group ◽

Adult Treatment Panel ◽

Cross Sectional ◽

Laboratory Parameters ◽

Number Of Patients ◽

Skin Tags

Background: The aim was to evaluate the parameters of metabolic syndrome in patients of skin tags and to investigate the possibility of an existing relationship between metabolic syndrome and skin tags.Methods: This cross-sectional observational study included 47 patients with skin tags attended Outpatient department (OPD) of Department of Dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.Results: This study included 47 patients with skin tags (28 males and 19 females). In the present study maximum number of patients belonged to the age group >40 years with 19 patients, followed by 30-40 years with 13 patient. In this study no. of students were 15, and no of employee were 11. Most patients had skin tags in more than one area, neck and axilla were involved in 9 patients each. In this study out of 47 patients. 11 patients had derangement of clinical and laboratory parameters of metabolic syndrome based on NCEP adult treatment panel III.Conclusions: In the present study we observed significant derangement of clinical and laboratory parameters of metabolic syndrome in patients of skin tags.

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Clinical Characteristics and Management of the Hydatid Cyst of the Liver: A Study from a Tertiary Care Center in Nepal

Journal of Parasitology Research ◽

10.1155/2020/8867744 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Utsav Joshi ◽

Roshan Subedi ◽

Amar Jayswal ◽

Vishakha Agrawal

Keyword(s):

Hydatid Cyst ◽

Imaging Finding ◽

Care Center ◽

Descriptive Analysis ◽

Tertiary Care ◽

Clinical Manifestations ◽

Public Health Problem ◽

Imaging Studies ◽

Abdominal Ultrasonography ◽

Number Of Patients

A hydatid cyst of the liver is a significant yet neglected public health problem in Nepal. The present study was carried out to evaluate the demographic characteristics, clinical presentations, and management of the patients of the hydatid cyst of the liver in the setting of a developing country. It was a retrospective, descriptive analysis of 53 patients admitted in the department of surgery with the diagnosis of hydatid cyst of the liver based on clinical manifestations, imaging studies, or serology between 2016 and 2019. The median age of the patients was 36 years, with the age group of 25-45 years being the most commonly affected (23, 43.4%). 58.5% of the patients were female. Abdominal pain (49, 92.5%) and a palpable liver (17, 32.1%) were the most common complaint and physical finding in our study population, respectively. Abdominal ultrasonography and computed tomography scan were the major imaging studies used to establish a diagnosis. A unilocular and anechoic cystic lesion was the most frequent imaging finding. The right lobe of the liver harbored the cysts in the maximum number of patients. Surgery was the preferred modality of treatment (23, 43.4%), with pericystectomy being the most common form of surgical intervention. The hydatid cyst of the liver is a common cause of morbidity in Nepal. Clinical evaluation supplemented by imaging studies is required for diagnosis, and surgery remains the treatment of choice in most cases. To explain the epidemiological pattern of the disease, multicentric studies involving a larger sample of patients should be conducted.

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EVALUATION AND SELECTION OF CANDIDATES FOR LIVER TRANSPLANTATION: AN ECONOMIC PERSPECTIVE

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202000000-07 ◽

2020 ◽

Vol 57 (1) ◽

pp. 31-38 ◽

Cited By ~ 1

Author(s):

Santiago RODRÍGUEZ ◽

Fabio Da MOTTA ◽

Giacomo BALBINOTO NETO ◽

Ajacio BRANDÃO

Keyword(s):

Liver Transplantation ◽

Care Center ◽

Tertiary Care ◽

Deceased Donor ◽

Waiting List ◽

Transplant Center ◽

Number Of Patients ◽

Common Problems ◽

Selection Of

ABSTRACT BACKGROUND: Over the next 20 years, the number of patients on the waiting list for liver transplantation (LTx) is expected to increase by 23%, while pre-LTx costs should raise by 83%. OBJECTIVE: To evaluate direct medical costs of the pre-LTx period from the perspective of a tertiary care center. METHODS: The study included 104 adult patients wait-listed for deceased donor LTx between October 2012 and May 2016 whose treatment was fully provided at the study transplant center. Clinical and economic data were obtained from electronic medical records and from a hospital management software. Outcomes of interest and costs of patients on the waiting list were compared through the Kruskal-Wallis test. A generalized linear model with logit link function was used for multivariate analysis. P-values <0.05 were considered statistically significant. RESULTS: The costs of patients who underwent LTx ($8,879.83; 95% CI 6,735.24-11,707.27; P<0.001) or who died while waiting ($6,464.73; 95% CI 3,845.75-10,867.28; P=0.04) were higher than those of patients who were excluded from the list for any reason except death ($4,647.78; 95% CI 2,469.35-8,748.04; P=0.254) or those who remained on the waiting list at the end of follow-up. CONCLUSION: Although protocols of inclusion on the waiting list vary among transplant centers, similar approaches exist and common problems should be addressed. The results of this study may help centers with similar socioeconomic realities adjust their transplant policies.

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PATTERN OF CANCER CASES REGISTERED IN A TERTIARY CARE CENTER IN KATHUA DISTRICT OF J&K: A CROSS SECTIONAL STUDY

10.36106/ijsr/0400712 ◽

2020 ◽

pp. 1-2

Author(s):

Deepak Abrol ◽

Anuj Kapoor ◽

Pawan Kumar

Keyword(s):

Care Center ◽

Tertiary Care ◽

Public Health Problem ◽

Cross Sectional Study ◽

Age Group ◽

Important Public Health Problem ◽

Cross Sectional ◽

Medical College ◽

Area Distribution ◽

The Government

Introduction:Cancer is an important public health problem in India, with 10 lakh new cases occurring every year in the year. Cancer pattern varies in different regions and depends on genetic, environmental, dietary, social and other factors. Aim and objectives: This study was undertaken to determine magnitude and pattern of cancer cases reporting in the hospital. Methodology: This was a hospital-based retrospective study undertaken in the Government Medical College Kathua. GMC, Kathua is one among st the ve new medical colleges established in Jammu & Kashmir. The records of cancer patients generated from 1st November 2018 to 1 November 2019 were analyzed. All the cancer cases who reported either for diagnosis in any of the hospital OPD or for the treatment (radiotherapy/ chemotherapy/ surgery) were included. Data was entered in the MS Excel for analysis Results: Out of total 272 patients registered, females accounted for 56.6% and males for 43.3%. Hindu patients were in majority (84.2%). Most of the cases (37.1%) were in the age group 60-80. Pattern of cancer was different in the two sexes. In males, maximum cases were of lung cancer and in females, Ca breast was the most common followed by the cervical cancer Conclusion: This hospital-based study indicates the cancer prole in Kathua district. Females were found to be more affected than that of males with majority of the cases in the late 40s age group. Rural area and urban area distribution was found to be almost similar.

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Pediatric Dental Emergency Pattern and Dental Care Provided during COVID-19 Pandemic Lockdown at a Tertiary Care Center in Kathmandu, Nepal

Journal of Nepalese Association of Pediatric Dentistry ◽

10.3126/jnapd.v2i1.41519 ◽

2021 ◽

Vol 2 (1) ◽

pp. 3-11

Author(s):

Senchhema Limbu ◽

Parajeeta Dikshit ◽

Manisha Malla ◽

Lokesh Verma ◽

Anju Khapung

Keyword(s):

Dental Care ◽

Pediatric Patients ◽

Care Center ◽

Tertiary Care ◽

Definitive Treatment ◽

Age Group ◽

Cross Sectional ◽

Common Diagnosis ◽

Dental Hospital ◽

Dental Emergency

Introduction: Pediatric dental management is difficult in its own way which was even more challenging during COVID-19 outbreak and lockdown period. Constrained dental providing clinics and hospitals severely compromised the pediatric dental needs and services. Objective: The aim of this study was to describe pattern of dental emergencies encountered and services provided to the pediatric patients visiting a dental hospital during the first lockdown period in Kathmandu, Nepal. Methods: A cross sectional study was done from 24 March 2020 to 21 July 2020 among the pediatric patients who visited dental hospital during lockdown. Data was collected from questionnaire and dental case history sheet, and statistically analyzed in Statistical Package of Social Sciences (SPSS) version 20. Results: Of the total 172 pediatric patients of mean age 8.3± 2.60 years, majority were males (59.3%) and of 6-12 age group (76.2%). Major complain was mobile/retained teeth (38.4%) and most common diagnosis was exfoliating mobility (23.3%). According to American Dental Association (ADA, 2020) guidelines, urgent dental care (46.5%) followed by non-emergency dental care (43.6%) were mostly found. The predominant procedures were emergency (68.6%) and least was elective (9.3%) and treatment given to majority was extraction (51.8%).There was a statistically significant association between age group and pediatric dental care (ADA). Conclusions: The findings of this study regarding dental emergency encountered and definitive treatment received even during pandemic lockdown can be helpful in finding out how dental care was provided and can be applicable in similar future pandemics.

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A Cross Sectional Study to Evaluate Cutaneous Manifestations in Diabetic Patients and their Correlation with Sugar Control at Tertiary Care Center in Western Maharashtra

VIMS Health Science Journal ◽

10.46858/vimshsj.8304 ◽

2021 ◽

Vol 8 (3) ◽

pp. 104-108

Author(s):

Dr. Ashutosh Chate ◽

Dr. Amrut Swami ◽

Ms. Sakshi Rane ◽

Dr. Ramesh Gosavi

Keyword(s):

Skin Diseases ◽

Care Center ◽

Tertiary Care ◽

Diabetic Patients ◽

Age Group ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

Skin Manifestations ◽

Significant Difference ◽

Study Participants

Introduction: Diabetes is a leading chronic disease in world and number of cases are significantly increasing each year in India also. Out of many associated conditions, skin involvement in diabetes also needs to be evaluated. We conducted this study to study relation between the sugar control and skin manifestations in diabetic patients. Methodology: We studied total 100 diabetic patients visiting our dermatology OPD over a period of 1 year from January to December 2020. All skin diseases in diabetic patients were studied. We studied association of these diseases with sugar control in our study participants. Results: Mean age of our study participants was 63.48 ± 18.12 years, Majority of the males were from the age group of 61 and above, 34 (62.96%) while majority of the females were from the age group of 41-60 years 25 (54.35%). Majority of the patients had diabetes for 5-10 years (52%) followed by more than 10 years (36%) and less than 5 years in 24% cases. Out of 100 participants, 44% had controlled diabetes while rest 56% had uncontrolled diabetes with HbA1c > 6. We observed a significant difference in skin manifestations of controlled and uncontrolled sugars in diabetic patients. (p = 0.007). Conclusion: From this study, we conclude that the skin is involved in diabetes quite often. Early diagnosis and treatment of skin manifestations in diabetic patients is important to reduce unwanted morbidity and further complications in the diabetic patients.

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Clinicoepidemiological Profile of Elderly PLHIV Attending a Tertiary Care Center in South India

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325957417742672 ◽

2017 ◽

Vol 16 (6) ◽

pp. 620-623 ◽

Cited By ~ 1

Author(s):

Deepak Madi ◽

Neha Ramakrishnan ◽

Bhaskaran Unnikrishnan ◽

John Ramapuram ◽

Basavaprabhu Achappa ◽

...

Keyword(s):

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

World Health ◽

Hiv Positive ◽

People Living With Hiv ◽

Age Group ◽

Elderly Age ◽

Cross Sectional ◽

Route Of Transmission

Background: Physicians are coming across a considerable number of HIV-positive patients belonging to older age-group, in practice. They pose a challenge as they might present with advanced forms and comorbid conditions. We aimed to describe the clinicoepidemiological profile of elderly people living with HIV. Methodology: We conducted a cross-sectional study at Kasturba Medical College, Mangalore. We analyzed the record of 120 patients from 2009 to 2014. Descriptive statistics were used to describe sociodemographic and clinical profile of patients. Results: Of 786 HIV-positive patients, 120 were elderly. Mean age was 55.9 ± 6.1 years. Majority 68% were male. In all, 63.33% were male. Commonest route of transmission was heterosexual intercourse, most presented at World Health Organization (WHO) stage 1 (64.17%). In all, 77.5% had hypertension and 26.6% had tuberculosis. The median CD4 count at presentation was 245 cells/mm3 (145-426 cells/mm3). Forty-two percent were late presenters (CD4 <200 cells/mm3). Conclusion: Treating physician should have a high index of suspicion in diagnosing HIV among elderly age-group.

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Retrospective Analysis of Early Impact of COVID-19 on Systemic Cancer Treatment—A Pilot Study

Indian Journal of Medical and Paediatric Oncology ◽

10.1055/s-0041-1730239 ◽

2021 ◽

Vol 42 (01) ◽

pp. 015-020

Author(s):

Anakha Pattiyeil ◽

Febin Antony ◽

Sunu L Cyriac ◽

Anilkumar Jose ◽

Jini M. P.

Keyword(s):

Cancer Care ◽

Medical Oncology ◽

Care Center ◽

Tertiary Care ◽

Significant Drop ◽

Relaxation Phase ◽

Number Of Patients ◽

Increased Risk ◽

The Impact

Abstract Introduction Cancer care during the coronavirus disease 2019 (COVID-19) pandemic is challenging as the patients are at an increased risk of developing complications compared with the general population. Objectives This study was conducted to assess the impact of COVID-19 pandemic and nationwide lockdown on systemic cancer care. Materials and Methods This comparative descriptive study was conducted in the Department of Medical Oncology and Haematology in a tertiary care center in India. The study compared and analyzed the consecutive patient data of two different units in the Department of Medical Oncology in the pre-COVID phase (PCP) and post lockdown relaxation phase (PLRP). We represented the categorical data in frequency and percentage, and chi-squared test was used to analyze the variables. Results Patients were categorized based on demographic, disease-related, and hospital visit-related parameters and a significant drop noted in patients who utilized a prebooking facility (p = 0.0001), in the number of patients aged >50 years (p = 0.004), number of patients who presented with hematological malignancies (p = 0.006), and who came for follow-up (p = 0.0001). The other parameters remained statistically insignificant. Conclusions During PLRP, active systemic cancer care seems to have been less affected, whereas follow-up of patients and visits of elderly patients were significantly reduced. If the pandemic remains under control, cancer care may not get compromised. This shows the importance of flattening the curve for quality management of other diseases during a pandemic.

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Hypocalcemia in Elderly Population in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5324 ◽

2020 ◽

Vol 58 (231) ◽

Author(s):

Sangita Thapa ◽

Rabindra Jang Rayamajhi

Keyword(s):

Serum Calcium ◽

Elderly Population ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Age Group ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

Introduction: As the medical facilities are improving, the life expectancy is increasing which has led to rapid rise in elderly population. The epidemiology of many diseases in elderly has been modified, including calcium imbalance. This study aims to know the prevalence of hypocalcemia in elderly population visiting a tertiary care center of Kathmandu. Methods: A descriptive cross-sectional study was conducted in a tertiary care center of Kathmandu from March to July 2020 after obtaining ethical clearance (Ref: 2003202007). Total 402 participants at or above 60 years of age groups visiting outpatient departments were included in the study by convenience sampling method excluding those under vitamin D and calcium supplements. Serum total calcium level was measured using standard routine method and corrected with albumin. The serum calcium value less than 8 mg/dl was considered as hypocalcemia in accordance with the reference range of our laboratory. Data analysis for calculation of frequency and proportion was done in Statistical Package of Social Sciences. Results: The prevalence of hypocalcaemia in elderly was found to be 97 (24.1%). Out of 286 participants of age group 60-74 years, hypocalcemia was seen in 75 (26.2%) and among 116 participants of age group >74 years, 22 (19%) were hypocalcemic. Among 181 male participants, 44 (24.3%) had hypocalcemia and out of 221 female participants, 53 (24%) had hypocalcemia. Conclusions: The finding of present study suggests that hypocalcemia is common among elderly which can be life threatening. Therefore, regular monitoring of serum calcium is recommended for this age group.

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