Epidemiological Profile and Determinants of Tuberculosis in Urban Nepalese Population

Introduction: Tuberculosis has evolved through ages to remain a major cause of morbidity and mortality worldwide. Despite having a very successful Directly Observed Treatment, Short-course program, tuberculosis is still one of the most widespread infections in Nepal. This study was done to observe the epidemiological profile of tuberculosis patients in an urban Nepalese population.Materials and Methods: 585 newly diagnosed cases of pulmonary and extrapulmonary tuberculosis in two tertiary level hospitals in the country were enrolled in the study during a period of 18months. A standard questionnaire was formatted and the required information was acquired with the help of interview and investigation reports.Results: The mean age of presentation was 35.76 with a male to female ratio of 1.48:1.57% of the cases had less than primary education with 26 % being illiterates. The most commonly involved occupational group was farmers (22%) followed by students (20%) and laborers (14%). 22% of cases had a history of contact with tuberculosis in the family. 41 % were smokers and 18 % abused alcohol. Pulmonary tuberculosis comprised 68% of the total cases. The most common extrapulmonary presentation was lymph node TB (28%) followed by pleural effusion (21.5%) and tubercular meningitis (16%).Conclusions: Young people with lower literacy levels and with a family history of tuberculosis are at increased risk of acquiring tuberculosis and community approaches for tuberculosis control should target this group to reduce the burden of the disease

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Stroke in a Subsaharan Nigerian Hospital—A Retrospective Study

Tropical Doctor ◽

10.1177/004947558901900104 ◽

1989 ◽

Vol 19 (1) ◽

pp. 11-14 ◽

Cited By ~ 19

Author(s):

S A Bwala

Keyword(s):

Duration Of Symptoms ◽

Female Ratio ◽

Transient Ischaemic Attacks ◽

History Of ◽

Hospital Deaths ◽

Insulin Dependent ◽

The Mean ◽

The University ◽

First Time ◽

Male To Female

The case records of 53 consecutive Nigerian inpatients with stroke in the University of Maiduguri Teaching Hospital, Maiduguri were retrospectively reviewed. The mean age at presentation was 55 years and the male to female ratio was 2.5: 1. The mean duration of symptoms before presentation was 11.1 weeks and the average duration of stay in hospital was 3 weeks. Thirty-three (63%) of the lesions were infarctive and 19 (37%) were haemorrhagic. Only 3 (6%) patients gave a history of prior transient ischaemic attacks (TIAs). Forty-two (79%) patients were hypertensive at presentation out of which 27 (64%) had the hypertension diagnosed for the first time. Four (8%) patients were non-insulin dependent diabetics. There were 11 hospital deaths (21%). Thus hypertension, more than half undiagnosed at admission, was the most common risk factor for stroke in the hospital population studied.

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Clinical Spectrum and Neuroimaging Changes in Neurodegenerative Disorder-Experiences in Tertiary Care Hospital of Bangladesh

European Journal of Clinical Medicine ◽

10.24018/clinicmed.2021.2.6.143 ◽

2021 ◽

Vol 2 (6) ◽

pp. 10-14

Author(s):

Gopen Kumar Kundu ◽

Rumana Islam ◽

Noor E-Sabah ◽

ABM Mukib

Keyword(s):

Neurodegenerative Diseases ◽

Tertiary Care Hospital ◽

Neurodegenerative Disorder ◽

Tertiary Care ◽

Clinical Manifestations ◽

Care Hospital ◽

Female Ratio ◽

History Of ◽

The Mean ◽

Male To Female

Neurodegenerative diseases (NDD) are a heterogeneous group of disorders characterized by progressive loss of previously acquired skills that are of varied etiology, clinical manifestations, and natural course. There is a paucity of data on clinical profile of neurodegenerative diseases in our population. We conducted a retrospective study with 68 diagnosed cases of NDD at a tertiary care hospital in Bangladesh. Among them, more than one-third of children were in 1-5 years age group. The mean age was 10.2±3.1 year and male to female ratio was 2:1. Fifty percent of cases had a history of consanguineous parents. Leukodystrophy was most common (30.88%) among NDDs, followed by Wilson disease (26.47), SSPE (22.1%), and Degenerative Ataxia (20.59%). Motor skill regression was the most common presentation (97%), followed by speech regression in 91% and Gait disorder in 83% of children. Seizure was presenting features in 24% of children. Neuroimaging abnormalities were found in 80.88% NDD cases. Among them white matter hyper intensity in 29.41%, cerabeller atrophy in 13.25 %, and cerebral atropy in 11.76% of children. Eye changes were found in about two-thirds (69.12%) of cases of NDD. Among them, optic atrophy was found in 29.41%, and KF rings in 25.00% of cases.

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Indications for destructive ocular surgeries in Nigeria

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v5i1.7817 ◽

2013 ◽

Vol 5 (1) ◽

pp. 24-27 ◽

Cited By ~ 2

Author(s):

KF Monsudi ◽

AA Ayanniyi ◽

AH Balarabe

Keyword(s):

Artificial Eye ◽

Ocular Surgery ◽

Female Ratio ◽

Common Indication ◽

History Of ◽

Ocular Tumours ◽

The Mean ◽

Willingness To Use ◽

Male To Female ◽

Type Of Surgery

Introduction: Destructive ocular surgery (DOS) means eye loss. An audit of its indications would be useful in reducing its incidence. Objective: To determine indications for destructive ocular surgeries. Materials and methods: The case records (files) of all the patients who had DOS in a tertiary health facility in Nigeria from January 2004 to December 2011 were reviewed retrospectively. The information extracted include the bio data, indication for DOS, type of surgery performed and history of the use of traditional eye medications (TEM) and willingness to use an artificial eye (AE). Results: Thirty-seven patients had DOS. The mean age of the patients was 35.51years (SD 21.6) and the male to female ratio was 2.1:1. Evisceration was the commonest DOS performed , in 30 eyes (81.1 %). The most common indication for DOS was intraocular infection, in 15 eyes (40.5 %), followed, among others, by trauma in 13 (35.1 %) and malignant ocular tumours in 4 (10.8 %). There was association between age and indication for DOS (P = 0.032). Many patients, 15 (40.5%), used TEM and most, 34 (91.9%), refused an artificial eye (AE) after surgery. Conclusions: The most common indication for DOS in this study was intraocular infection. Evisceration was the commonest destructive eye surgery offered. Nepal J Ophthalmol 2013; 5(9):24-27 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7817

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Predictors for the recurrent febrile seizures after the first complex febrile seizures

Paediatrica Indonesiana ◽

10.14238/pi46.5.2006.204-8 ◽

2016 ◽

Vol 46 (5) ◽

pp. 204

Author(s):

Conny Tanjung ◽

Irawan Mangunatmadja ◽

Sudigdo Sastroasmoro ◽

I. Budiman

Keyword(s):

Body Temperature ◽

Cox Regression ◽

Age At Onset ◽

Febrile Seizures ◽

Bivariate Analysis ◽

Female Ratio ◽

Predictors Of Recurrence ◽

The Family ◽

The Mean ◽

Male To Female

Background Complex febrile seizures (CFS) have been shownto be related to recurrence and epilepsy. Many studies were doneto determine the predictors of recurrence in both simple and com-plex febrile seizures. To our knowledge until now there is no pub-lished data that specially looks for predictors of recurrence after afirst CFS.Objective To find out clinical and demographical characteristicsof a first CFS and to define the predictors for the recurrent febrileseizures.Methods Prospective survival analysis study was done in chil-dren with first CFS who visited Cipto Mangunkusumo Hospital,Jakarta, over 14 months periods. The predictors for developmentof recurrence were analyzed by SPSS for Windows 11.5 usingKaplan-Meier test and Cox regression model with a level of signifi-cance <0.05.Results There were 62 subjects completed this study. Male-to-female ratio was 1.4:1. The mean age at onset was 18.2 months.Recurrence occurred in 9 subjects (14.5%). Body temperaturebetween 38-38.5°C (7 of 26 subjects, P=0.02), upper motor neu-ron type of delayed development (3 of 7 subjects, P=0.03), andepileptic history in the family (2 of 2 subjects, P<0.05) were asso-ciated with recurrence in bivariate analysis. In multivariate analy-sis only body temperature between 38-38.5°C (HR 1.6, 95% CI1.0;23.9) and epileptic history in the family (HR 16.9, 95% CI2.8;101.4) were identified as predictors.Conclusion Low body temperature at the first seizures and epi-leptic history in the family were independent predictors for the re-currence after a first CFS

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Sociodemographic, Clinical Profile and Outcome of Tuberculosis in Baramulla District of North Kashmir of India

JMS SKIMS ◽

10.33883/jms.v21i1.336 ◽

2018 ◽

Vol 21 (1) ◽

pp. 11-16

Author(s):

Abdul Ahad Wani ◽

Javeed Iqbal Bhat ◽

Muzafar Naik ◽

Nisar Ahmed Dar ◽

Syed Masood Ahmed

Keyword(s):

Elementary Education ◽

Pulmonary Tuberculosis ◽

Rural Areas ◽

Extrapulmonary Tuberculosis ◽

Steady Increase ◽

Female Ratio ◽

Directly Observed Treatment ◽

Night Sweats ◽

Immunodeficiency Syndrome ◽

A Prospective Study

Background: India accounts for one-fourth of the global tuberculosis (TB) burden. Since the countrywide implementation of RNTCP, tuberculosis care has received renewed focus. Directly observed treatment short-term (DOTS) is a cornerstone of RNTCP program. Objective: To evaluate demographic profile, clinical presentation and outcome of TB in district Baramulla of North Kashmir. Methods: A prospective study over a period of seven years in patients diagnosed with TB in district Baramulla of North Kashmir. Results: This study was conducted prospectively over seven years from March 2011 to February 2017. A total of 802 patients were enrolled in the study. Among them, there were a total of 638 adult patients and 164 paediatric patients with a male: female ratio of 1:0.99. Majority of patients belonged to rural areas of north Kashmir and had received no or elementary education. Pulmonary tuberculosis was diagnosed in 530 (66 %) patients and 272 (34%) patients were diagnosed as extrapulmonary tuberculosis. Sputum for AFB was important mode of diagnosis in our series and was positive in 525 (65%) our patients. Majority of patients presented with fever, weight loss, and night sweats. None of the patients had Acquired Immunodeficiency syndrome (AIDS). There was a consistent improvement in AFB isolation among TB patients over the study period. Majority of our patients were cured completely of disease Conclusion: Sputum positive pulmonary tuberculosis remains the most common presentation of tuberculosis in North Kashmir. There is a steady increase in the proportion of bacteriologically confirmed TB cases over the study period. Furthermore, DOTS treatment is successful in all forms of tuberculosis. JMS 2018;21(1):11-16

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Elevation of pulse pressure in middle age is associated with the risk of dementia: data from a population-based cohort

European Heart Journal ◽

10.1093/ehjci/ehaa946.2738 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

D Kim ◽

H Jung ◽

P.S Yang ◽

H.T Yu ◽

T.H Kim ◽

...

Keyword(s):

Blood Pressure ◽

Pulse Pressure ◽

Middle Age ◽

Population Based ◽

Entire Cohort ◽

Incident Dementia ◽

Increased Risk ◽

Diagnosis Of Dementia ◽

History Of ◽

The Mean

Abstract Aims Pulse pressure (PP) is a well-known risk factor for cardiovascular disease. However, the association between the PP and dementia is not well identified. This study aimed to determine the effect of PP on the risk of dementia development in different age subgroups using a longitudinal, population-based, and stroke-free cohort from the general population. Methods The association of PP with the development of incident dementia was assessed from January 1, 2005, to December 31, 2013, in 433,154 participants without a history of dementia or stroke from the Korea National Health Insurance Service-Health Screening cohort. The diagnosis of dementia was defined using the 10th revision of the International Classification of Disease codes. Results The mean age of the cohort was 55.7±9.2 years, 45.7% were women. Hypertension was 23.6%. The mean systolic and diastolic blood pressure of the entire cohort were 125.9±16.6 and 78.4±10.7 mmHg, respectively. Mean PP was 47.5±10.9 mmHg. In the middle-age group (40 to 50 year-old), increasing of 10 mmHg of PP was associated with incident dementia after adjusting mean blood pressure and clinical variables with a hazard ratio (HR) of 1.21 (95% confidence interval [CI]: 1.19–1.23, p<0.001). The association was still significant even after censoring for stroke (HR: 1.16, 95% CI: 1.08–1.22, p<0.001). In the older population, elevation of PP was not associated with dementia development (HR: 0.98, 95% CI: 0.95–1.01, p=0.247) Conclusion PP was associated with increased risk of dementia only in middle-aged population beyond that of mean arterial pressure. Funding Acknowledgement Type of funding source: None

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P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽

10.1093/bjsopen/zrab032.128 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

Apoorva Khajuria ◽

Tuba Rahim ◽

Mariam Baig ◽

Kai Leong ◽

Apoorva Khajuria

Keyword(s):

Inflammatory Bowel Disease ◽

Perianal Abscess ◽

Female Ratio ◽

Incision And Drainage ◽

Common Presentation ◽

History Of ◽

Inflammatory Bowel ◽

Operative Findings ◽

The Cost ◽

Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

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Time trend and clinical pattern of extrapulmonary tuberculosis in Serbia, 1993-2007

Vojnosanitetski pregled ◽

10.2298/vsp1203227p ◽

2012 ◽

Vol 69 (3) ◽

pp. 227-230 ◽

Cited By ~ 3

Author(s):

Dragica Pesut ◽

Milica Bulajic ◽

Aleksandar Lesic

Keyword(s):

Incidence Rate ◽

Census Data ◽

Economic Transition ◽

Transition Period ◽

Extrapulmonary Tuberculosis ◽

High Coverage ◽

Female Ratio ◽

Bcg Vaccination ◽

Tb Treatment ◽

Directly Observed Treatment

Background/Aim. Increased incidence of extrapulmonary tuberculosis (XPTB) is reported worldwide. Serbia is a country in socio-economic transition period with lowmiddle HIV prevalence and intermediate-to-low tuberculosis (TB) incidence rate, 100% directly observed treatment (DOT) coverage, and mandatory BCG vaccination at birth. The aim of the study was to examine the incidence trend and clinical features of XPTB in Serbia during a 15-year period. Methods. This retrospective observational study included XPTB cases diagnosed in the period between 1st January 1993 and 31st Decembre 2007, according to the reports of the National Referral Institute of Lung Diseases and Tuberculosis in Belgrade and Central Tuberculosis Register. Population estimates with extrapolations were based on 1991 and 2002 census data. Results. While the overall TB incidence rate showed a slight, not significant decreasing trend (p = 0.535), a significant increase was found for XPTB (y = 1.7996 + 0.089x; R2 = 0.4141; p = 0.01). A total of 2,858 XPTB cases (newly diagnosed and 10% relapses) gave an average age specific incidence rate of 2.51/100,000 population (95% confidence interval, SD = 0.6182) with 8.9% annual increase. The male-to-female ratio was 0.54. Lymph nodes were most frequently affected site (48.5%) followed by genitourinary (20.5%), pleural (12%), and osseo-arthicular (10.3%) TB. Treatment outcome was successful in 88.29% of patients (cured and completed), 3.64% died, 5.18% interrupted, 0.57% displaced, and 2.3% unknown. Conclusion. Increasing trend of XPTB incidence rate may be a result of increased morbidity due to still present risk factors, possible higher detection rate in Serbia and better notification. A high coverage of newborns with BCG vaccination at birth might contribute to a decreased number and rare XPTB cases in children.

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DEMOGRAPHIC PROFILE OF ACUTE FEBRILE ENCEPHALOPATHY CASES IN PEDIATRIC AGE GROUP PATIENTS: A STUDY FROM WESTERN RAJASTHAN

10.36106/ijsr/1302690 ◽

2021 ◽

pp. 72-73

Author(s):

Laxmi Rathore ◽

P. K. Khatri ◽

Saroj K. Meena ◽

Archana Bora ◽

Suneel Bhooshan

Keyword(s):

Lower Class ◽

Mental States ◽

Clinical Feature ◽

Female Ratio ◽

Pediatric Age Group ◽

History Of ◽

Laboratory Investigations ◽

Demographic Distribution ◽

Viral Etiologies ◽

Male To Female

Acute Febrile Encephalopathy is a clinical term used to describe patients presenting with short febrile illnesses with altered mental states. Demographic distribution plays an essential role in the diagnosis of viral etiologies. One hundred ve suspected AFE cases were enrolled in the study. A detailed history by predesigned performa and laboratory investigations was obtained for data collection. Viral etiology was diagnosed in 32 (30.48%) cases. The male to female ratio was 1.39:1. Total 56.25% of positive cases were from the lower class, 28.13% from the middle class, and 15.63% from the upper class. 24 (75%) cases from rural, while only 8 (25%) of the urban population showed viral etiologies. In 19 (59.4%) cases were either history of incomplete vaccination or not vaccinated, 13 (40.6%) cases had a history of complete immunization among positive cases. The predominant clinical feature was fever (100%) followed by seizures 66(62.86%), vomiting 37(35.24%), headache 14(13.33%), paresis in 16(15.24%) and altered sensorium in 29(27.62%), respectively. To conclude, the etiologic panorama of AFE varies with several factors such as time and demographical location, age, and immunization status. There is an urgent need to conduct more studies to prole the viral etiologies according to their prevalence in geographical areas so the treatment can be tailored accordingly and prophylaxis treatment or immunization can be boosted in the population at risk of getting the disease.

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COMPARISON OF CLINICO-SOCIAL PROFILE OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL IN A RURALAREA: A RETROSPECTIVE STUDY

10.36106/ijsr/4605295 ◽

2021 ◽

pp. 70-72

Author(s):

Gaurav Santosh Nemade ◽

Sumit Nitin Dhus ◽

Arushi Ramesh Shetty ◽

Neha Dhananjay Firake

Keyword(s):

Tertiary Care ◽

Care Hospital ◽

Female Ratio ◽

Extra Pulmonary Tuberculosis ◽

Younger Age ◽

Tobacco Addiction ◽

History Of ◽

Early Case ◽

Male To Female ◽

Clinical Characteristic

BACKGROUND AND OBJECTIVES: The burden of tuberculosis (TB) in India is the highest accounting for 26% of the global incidence. A total of 1.4 million people died from TB in 2019 (including 208 000 people with HIV). India accounts for a fourth of the global burden of TB and 29% of global mortality. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristic between pulmonary TB (PTB) and extrapulmonary TB (EPTB). MATERIALS AND METHODOLOGY:Aretrospective analysis was carried of 348 patients diagnosed in DOTS centre, Pravara Rural Hospital, Loni. Characteristics of demographic and clinical characteristics were obtained from medical case records. RESULTS:Among the 348 cases, 71.3% were PTB and 28.7% were EPTB including, pleural (36%), meningeal (27%) and lymphatic (20%) cases. The male to female ratio in PTB and EPTB are 1.99 and 1.22 respectively. EPTB was more common at younger age (<25 years). Tobacco addiction (10.9%), diabetes mellitus (4.03%), HIV positivity (12.1%) and history of contact with Tb patients (17.7%) were more likely to be associated with PTB. CONCLUSION:Increased awareness of the risk factors may facilitate early case nding and better management outcomes for these patients.

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