scholarly journals Clinicoepidemiological Profile of Pityriasis Versicolor in a Tertiary Care Hospital in Kathmandu, Nepal

2019 ◽  
Vol 21 (4) ◽  
pp. 294-300
Author(s):  
S Shrestha ◽  
P Koirala ◽  
U Timothy

Pityriasis versicolor (PV) also known as Tinea versicolor is a benign, chronic superficial fungal infection of the skin caused by Malassezia furfur. It is characterized by dyspigmented macules with fine branny scales. The purpose of this study was to assess the epidemiological profile and clinical pattern of PV in a group of patients visiting a tertiary care centre of Nepal. A descriptive cross-sectional study was carried out including 150 patients diagnosed to have PV at the outpatient dermatology department of Nepal Medical College Teaching Hospital. Patients with the diagnosis of PV were included in the study. A detailed history was taken and it was followed by a thorough clinical examination. The findings of history and clinical examinations were documented in a predesigned proforma. Statistical Package for the Social Sciences (SPSS) version 16 was used to tabulate the data and analyze the results. There was a slight male preponderance with maximum patients of the age group 11 – 20 years. A majority of patients were students. Forty three (28.7%) patients had similar problem in close contacts and 42% had recurrent disease. Wearing of occlusive synthetic clothing was the commonest predisposing factor. Upper chest and upper back were the most involved sites. Hypopigmented macules were the commonest lesions in 72.7%. Coexisting seborrheic dermatitis (commonly pityriasis capitis ) was present in 44.67% of patients. Clinicoepidemiological profile of PV in our setting is similar to many studies done mostly in India. But few findings differ which indicates the need for further studies in Nepal especially from Terai regions where the prevalence is expected to be more.

Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.


Author(s):  
Swathi Karanth M.P ◽  
Somashekar M ◽  
Anushree Chakraborty ◽  
Swapna R ◽  
Akshata J.S ◽  
...  

Background: The shorter regimen was widely accepted and advocated for MDR-TB treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens in a programmatic setting will help in tailoring the treatment regimen of MDR-TB. Objectives: 1. To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen. 2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions in the shorter MDR-TB regimen. Methods: A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens were recorded. Treatment success is defined as ‘disease cured and treatment completed’, whereas treatment failure was considered when the treatment was either terminated or changed due to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion in the continuation phase. Results: The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher with a shorter MDR-TB regimen (p=0.0001). Conclusion: Treatment success with the shorter MDR-TB regimen though higher than the conventional regimen, is still way behind the target treatment success rate. Improving treatment adherence remains pivotal for achieving end TB targets.


2017 ◽  
Vol 16 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Mohammad Arif Shahar ◽  
Ahmad Marzuki Bin Omar ◽  
Azarisman SM Shah ◽  
Mohammad Hadzri Hasmoni ◽  
...  

Objective: Patients beliefs determine their response to an illness and its management especially if it is chronic. Studies assessing patient’s knowledge of their epilepsy are scarce. We report the first objective study evaluating knowledge, attitude and practices of epilepsy patients referred to a tertiary care centre in East Coast of Malaysia.Materials and Methods: A cross sectional study using pre-tested, semi-structured questionnaire among consenting epilepsy patients.Results: The demographic details and responses to a questionnaire assessing their insight towards epilepsy were recorded. Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean = 31.63 ± 13.41). Majority (53.8%) of them aged equal or less than 30 years. The median number of years they had epilepsy was 8.0 (4.0, 18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (0.3, 4.5) years. The average number of years they were receiving treatment from a hospital was 5.50 ± 5.84. Most (90.9%) did not know the cause of epilepsy; however 93.9 % were aware that it can be treated with modern drugs. While only 22.7 % believed that faith healers can treat epilepsy, 74.2% had tried other forms of treatment. Negative attitude was reflected in the belief that epilepsy is due to supernatural powers (1.5%) and that epilepsy is contagious (17.4 %). Positive attitude included that PWE can take a job (66.7%), allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (54.5%), marry (65.9%) and having children (58.3%).Conclusions: Patients with epilepsy are not knowledgeable about their disorder. This is true regardless of age, educational background, or number of years with epilepsy. The results suggest that there is a critical need to enhance epilepsy education and improve attitudes towards epilepsy beyond seizure control.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.545-553


Author(s):  
Ashis Samuel John ◽  
Kamaxi M. Bhate

Background: Inadequate understanding by patients of medical prescription given to them adversely affects treatment compliance; which can result in treatment failure and increase the incidence of adverse effects. The study site is a tertiary care hospital in a metropolitan city and the patients attending here are particularly vulnerable in this regard both due to the heavy patient load in the outpatient department and their low socioeconomic status.Methods: This was a cross sectional study conducted in the pharmacy of K.E.M. Hospital, Mumbai over a period of 1 month. Study population included general outpatient department patients of the hospital. Patients were interviewed using a pre validated questionnaire and their knowledge of the prescription analysed under five key aspects including dose, timing, duration, side effects and purpose of each drug. Data was entered using Microsoft Excel and analyzed using SPSS 22 software.Results: The mean age of the population was 37.6, with a standard deviation of 12.4. A good overall knowledge of the prescription was present only in 12.4% patients. In 52% of patients, the level of knowledge ranged from ‘no knowledge to little knowledge’. Age and literacy had statistically significant associations with overall knowledge of prescription.Conclusions: There is a significant gap in prescription knowledge in the study population. Age and literacy of the patient has an effect on prescription knowledge.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Neelam Joshi ◽  
Asim Shrestha ◽  
Deepika Karki ◽  
Pradip Man Singh

Introduction: Adolescence is the time when most mental illness begins most of the time these problems are overlooked leading to increased morbidity and mortality. The study is undertaken to find out the prevalence of psychiatric disorders in adolescents attending psychiatry outpatient department in a tertiary hospital. Methods: A descriptive cross-sectional study was done from 1st December 2019 to 29th November 2020 at a tertiary care centre of Kathmandu. Ethical approval (Ref No.: 012-076/077) was taken from the Institution Review Committee. A semi-structured proforma was used for the socio-demographic profile of patients and International Classification of Diseases-10 was used to make the diagnosis. Data were analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 174 adolescents were included in the study. Out of the total cases 141 (81.03%) (75.1-86.8 at 95% Confidence Interval) were diagnosed with psychiatric disorders, among them 73 (51.77%) were males and 68 (48.23%) were females. The common diagnoses were anxiety disorders 63 (36.20%), mood disorders 34 (19.54%), psychotic disorders 26 (14.94%), substance use disorders 8 (4.59%), non-organic sleep disorders 5 (2.87%), behavioral and emotional disorders 3 (1.72%) and mental retardation 2 (1.149%). Conclusions: Prevalence of psychiatric illnesses is high in the adolescent population compared to the similar studies.


2019 ◽  
Vol 10 (3) ◽  
pp. 1832-1835
Author(s):  
Nithyananthan P ◽  
Jagadeesan M ◽  
Prasanna Karthik S ◽  
Kannan R ◽  
Bavithra K ◽  
...  

In the Indian society, various factors other than mere knowledge have shown to have a more significant impact over contraceptive usage and choice such as educational levels of women, marital duration, cultural and social factors, and exposure to mass media. This study focuses on assessing the knowledge, attitude and practices (KAP) of contraceptive use among married women. A cross-sectional study was conducted among married women aged between 18 to 49 years attending a tertiary care hospital in the city of Chennai from June to September 2018. A total of 146 women were interviewed, and the KAP parameters were assessed using a pretested structured questionnaire. Though 97.9% (n=143) of the women in this study had knowledge about some form of contraception, only 24.7% (n=36) practiced them. Among the users (n=36), the decision to adopt contraception was made by the husband in 69.4% (n=25).Among the non-users (n=110), the major reasons for not practicing contraception were lack of interest in 37.2%(n=41) and fear of side effects in 35.5% (n=39).This study demonstrates a significant gap between the knowledge and practice of contraceptives in our population. Improving doctor-patient relationship and encouraging a positive attitude of the husband towards contraception are the key factors in promoting adoption of the contraceptive practices.


2017 ◽  
Vol 13 (3) ◽  
pp. 261-267
Author(s):  
S. Shakya Shrestha ◽  
M. Bhandari ◽  
R. Shrestha ◽  
S.R. Thapa ◽  
A. Karki ◽  
...  

Background Corticosteroids are highly effective drugs with anti-inflammatory and immunosuppressive properties. Due to this, they have become a mainstay of pharmacotherapy in dermatology. However, improper and long term uses are associated with a number of serious adverse effects.Objective To investigate the corticosteroids use pattern, adverse effects and various factors associated with adverse effects in dermatological practice.Method A cross-sectional study was conducted in a dermatology department of tertiary care hospital. All patients using at least one corticosteroids, either topically or systemically or the combination were included in this study. Informed consent was taken from the patients and interviewed using structured questionnaire. Statistical analysis was performed by using SPSS 20. p-value < 0.05 was considered as statistically significant.Result Among the 60 participants under this study, 81.67% of them were females. The mean (±SD) age of the patients was 31.03 years (±15.0). A majority (58.30%) of the patients was prescribed with topical corticosteroids with low potency (25%). Most of them had used corticosteroids for urticaria. Adverse effects were reported by 33.30% of the patients. The most common adverse effect reported was the shedding of skin. Adverse effects was significantly associated with gender; use of systemic corticosteroids; regular use of corticosteroids; discontinuation of dose abruptly; and missed dose. However, there was no significant association between adverse effects and the duration of use of corticosteroids.Conclusion In conclusion, the present study suggested that the proper counselling and clear instruction regarding the use of corticosteroid should be provided to the patients for avoiding the abrupt discontinuation of the prescribed medication leading to treatment failure.


2019 ◽  
Vol 15 (3) ◽  
pp. 156-159
Author(s):  
Rupak Bishwokarma Ghimire ◽  
Sabina Bhattarai ◽  
Govinda Pokharel ◽  
Eliz Aryal ◽  
Prashanna Raj Shrestha

Background: An adverse cutaneous reaction caused by a drug is any undesirable change in the structure or function of the skin, its appendages or mucous membranes and it encompass all adverse events related to drug eruption, regardless of the etiology.  Methods: This is a retrospective descriptive cross-sectional study done fom April 2017 to March 2019 at dermatology department of Kathmandu Medical College Teaching Hospital. Sample size was calculated as 42 with prevalance of severe cutaneous drug eruption as 3%. After the medication history was taken, all suspected causative drugs were discontinued. For the initial 5 to 7 days, all patients were treated with intravenous corticosteroids and oral antihistamines. Follow up after one week, 2 weeks and one month were suggested for assessment of outcomes. Results: Out of 42 patients, 22 (52.38%) were females and 20 (47.62%) males. Most were in age groups 16-39 & 46-60 counting to 14 (33.33%) in each group. Acute morbilliform eruption was the most common presentation 20 (47.6%) followed by Steven Johnson Syndrome-Toxic Epidermal Necrolysis in 16 (38.1%). The most common offending drug group in this study was antileptics 9 (21.43%), followed by NSAIDs 8 (19.05%), antibiotics 7 (16.67%), allopurinol 4(9.52%%). Patients were discharged after 7 days with tapering dose of oral prednisolone upto 6 weeks for all patients. However, three patients died due to Toxic Epidermal Necrolysis along with comorbid conditions like intracerebral hematoma, COPD with pneumonia. Conclusion: Adverse cutaneous drug reactions should be recognized early for timely intervention. Previously sensitized patients should be made aware about fatal outcomes, symptoms, cross reactivites as well as over the counter preparations.


Author(s):  
Rupali A. Patle ◽  
Ashok R. Jadhao ◽  
Priya B. Dhengre ◽  
Manjusha A. Dhoble

Background: The covid pandemic started from Hubei, Wuhan in December 2020 then covered many other countries including India. Understanding the demographic and clinical characteristics of deceased COVID-19 patients could inform public health interventions focusing on preventing mortality due to COVID-19. The present study was done with the objective of studying the socio-demographic and clinical profile of deceased patients with coronavirus disease.Methods: This is a hospital based cross-sectional study on 1190 deceased patients of coronavirus disease in a tertiary care hospital of central India which is a dedicated covid hospital from 11 March 2020 to 28 February 2021. Socio-demographic and clinical characteristics of deceased patients were recorded.Results: Overall case fatality rate was 13.24%. Maximum number of deaths occurred in the month of August 2020 and September 2020 were 372 (31.26%) and 477 (40.08%). It was higher in the males 791 (66.47%) as compared to females 399 (33.53%), but the difference was not significant. The most common symptom was fever on hospitalization 924 (77.65%), followed by generalized weakness 771 (64.79%). 352 (29.58%) patients died within 24 hours of the admission to hospital. Hypertension and type 2 diabetes mellitus were the most prevalent morbidity in 557 (46.80%) and 357 (30.00%). It was found that 232 (19.50%) deceased patients had oxygen saturation less than 50% on admission.Conclusions: Higher age and presence of co-morbidities at the time of admission were significantly associated with mortality.


2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Rupak Bishwokarma Ghimire ◽  
Khilasha Pokhrel ◽  
Sanjubabu Shrestha

Introduction: Pyoderma is defined as any purulent skin disease and represents infections inepidermis and dermis or hair follicles. This study aims to find out the prevalence of communityacquired pyoderma in dermatological outpatient department of a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out among patients who presented atdermatology outpatient department of Kathmandu Medical College Teaching Hospital betweenDecember 2018 and March 2019 after ethical clearance from institutional review committee.Convenience sampling method was done. Data was collected and analysis was done using SPSSsoftware, point estimate at 95% CI was calculated along with frequency and proportion for binarydata. Results: Out of 385 cases, 72 (18%) cases were of community-acquired pyoderma. Prevalence ofcommunity-acquired pyoderma is 72 (18%) at 95% CI(). Primary pyoderma was seen in 49 (12.72%)mainly folliculitis 17 (4.41%), furunculosis 16 (4.15%), impetigo 6 (1.55%), abscess 6 (1.55%) andbacterial paronychia 4 (1.03%). Staphylococcus aureus was the most common organism isolated in 42(58.3%) cases and Staphylococcus epidermidis was isolated in 3 (4.17%) cases. Staphylococcus aureuswas most sensitive to Vancomycin 42 (100%) followed by Gentamycin 40 (95.2%), Ciprofloxacin 40(95.2%) and Ceftriaxone 40 (95.2%). Highest resistance was seen to Azithromycin in 13 (30.95%),followed by Cloxacilllin in 11 (26.19%). Males were affected predominantly in 49 (68.06%) ascompared to females in 23 (31.94%). Conclusions: Prevalence of community-acquired pyoderma is high among patients visitingdermatological outpatient departments of a tertiary care hospital compared to other studies.Antibiotic resistance of commonly used antibiotics are increasing and thus proper cultureand sensitivity reports may be required to guide our treatment


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