Evaluation of Hyponatremia among Psychiatric Inpatients: A Preliminary Local Appraisal

Introduction: Hyponatremia is one of the most frequent ion and water disorders and severe hyponatremia is associated with well-known clinical symptoms and manifestations. In the present assessment the incidence and clinical profile of hyponatremia have been probed among a great sample of non-western psychiatric inpatients and compared with the available data in literature regarding prevalence and other associated clinical characteristics. Methods: All inpatients with idiopathic hyponatremia during the last sixty-four months had been included in the present study. Clinical diagnosis, as well, was in essence based on ‘Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)’. Statistical significance had been defined as a p value ≤0.05. Results: While the annual incidence of hyponatremia in current evaluation was around 0.01%, the annual incidence of mortality due to hyponatremia was around 0.001%. It was significantly more prevalent among male psychiatric inpatients (p<0.04) and patients with duration of illness in excess of one year (p<0.04). Furthermore it was meaningfully more evident among schizophrenic patients (p<0.007), in comparison with remaining primary psychiatric disorders. There was no significant relationship between hyponatremia and symptomatic profile, or serum level of sodium and occurrence of seizure. Conclusion: Hyponatremia was significantly more prevalent among male patients and cases with duration of illness in excess of one year. Furthermore it was meaningfully more evident among schizophrenic patients.

Download Full-text

Suicide in psychiatric inpatients in Ireland

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700005498 ◽

1999 ◽

Vol 16 (4) ◽

pp. 127-131 ◽

Cited By ~ 7

Author(s):

Eleanor Corcoran ◽

Dermot Walsh

Keyword(s):

General Population ◽

Suicide Rate ◽

Psychiatric Inpatients ◽

Time Interval ◽

Hospital Inpatient ◽

Fourfold Increase ◽

Suicide Rates ◽

Duration Of Illness ◽

Secure Environment ◽

One Year

AbstractObjectives:To establish suicide rates of psychiatric inpatients in Ireland and the characteristics, demographic, social and medical, of the patients involved.Method:Clinical, post mortem and inquest data on all such deaths from 1983-1992 were examined. Suicide rates were calculated using ‘person year method’.Results:The suicide rate for short stay inpatients (stay less than one year) was 319/100,000, and 118/100,000 for long stay patients. The average duration of illness at time of suicide was 10 years. A fourfold increase in suicide rate of inpatients over the century was associated with a similar increase in the suicide rate in the general population. Thirty five per cent of suicides were aged 25-34 years. The risk of suicide was higher the shorter the time interval after admission. Three quarters of suicide deaths in registered inpatients occurred away from hospital grounds.Conclusions:Social factors which contribute to an increase in the suicide rate in the general population are relevant to the increase in hospital inpatient suicides. More effective and comprehensive services to meet the needs of those with severe mental illness, particularly young adults, are essential. The results emphasise the importance of managing inpatients in a safe, secure environment. The person year method is appropriate for monitoring changes in suicide rates.

Download Full-text

Primary intra-articular osteotomy for varus malunion of the medial condyle of the tibial plateau

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200208 ◽

2020 ◽

Vol 6 (2) ◽

pp. 360

Author(s):

Jeremy Bliss ◽

Dan Barnabas Inja ◽

Manasseh Nithyananth ◽

Vinoo Mathew Cherian

Keyword(s):

Functional Outcome ◽

Tibial Plateau ◽

Statistical Significance ◽

P Value ◽

Medial Condyle ◽

Medial Condyle Fracture ◽

Excellent Functional Outcome ◽

Male Patients ◽

Condyle Fracture

Background: Reconstructive operative procedures for post-traumatic deformities of the tibial plateau have been described in literature, though rarely. We report short term follow-up of eleven such cases of primary intra-articular osteotomy.Methods: From 2005 through 2011, a primary intra-articular osteotomy for varus malunion of the medial condyle of the tibial plateau was performed in eleven consecutive cases. The patients were assessed clinically and radiologically at a minimum of 28 months post-operatively. The functional outcome was assessed using Rasmussen score. Paired ‘t’ test was used to determine the statistical significance.Results: There were eleven male patients. Average follow up was 59 months (range 28 to 159). Articular congruity was restored to acceptable in all patients and varus malalignment was corrected from a mean of 1.5 degrees varus to 5.7 degrees of valgus (statistically significant, two-tailed P value of 0.0056) to an extent comparable to the normal side (mean 5.8 degrees). There were no infections. All patients had good to excellent functional outcome.Conclusions: A primary intra-articular osteotomy and osteosynthesis for malunited medial condyle fracture of the tibial plateau would help to restore mechanical alignment and improve functional outcome.

Download Full-text

Preoperative bisphosphonate treatment may adversely affect the outcome after shoulder arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.101b2.bjj-2018-0906.r1 ◽

2019 ◽

Vol 101-B (2) ◽

pp. 147-153 ◽

Cited By ~ 3

Author(s):

D. H. Mai ◽

C. Oh ◽

M. E. Doany ◽

A. S. Rokito ◽

Y. W. Kwon ◽

...

Keyword(s):

Postoperative Complications ◽

Shoulder Arthroplasty ◽

Intraoperative Complications ◽

Statistical Significance ◽

Previous Treatment ◽

Primary Outcome Measure ◽

Postoperative Outcomes ◽

Bisphosphonate Treatment ◽

Male Patients ◽

One Year

Aims The aim of this study was to investigate the effects of preoperative bisphosphonate treatment on the intra- and postoperative outcomes of arthroplasty of the shoulder. The hypothesis was that previous bisphosphonate treatment would adversely affect both intra- and postoperative outcomes. Patients and Methods A retrospective cohort study was conducted involving patients undergoing arthroplasty of the shoulder, at a single institution. Two patients with no previous bisphosphonate treatment were matched to each patient who had received this treatment preoperatively by gender, age, race, ethnicity, body mass index (BMI), and type of arthroplasty. Previous bisphosphonate treatment was defined as treatment occurring during the three-year period before the arthroplasty. The primary outcome measure was the incidence of intraoperative complications and those occurring at one and two years postoperatively. A total of 87 patients were included: 29 in the bisphosphonates-exposed (BP+) group and 58 in the non-exposed (BP-) group. In the BP+ group, there were 26 female and three male patients, with a mean age of 71.4 years (51 to 87). In the BP- group, there were 52 female and six male patients, with a mean age of 72.1 years (53 to 88). Results Previous treatment with bisphosphonates was positively associated with intraoperative complications (fracture; odds ratio (OR) 39.40, 95% confidence interval (CI) 2.42 to 6305.70) and one-year postoperative complications (OR 7.83, 95% CI 1.11 to 128.82), but did not achieve statistical significance for complications two years postoperatively (OR 3.45, 95% CI 0.65 to 25.28). The power was 63% for complications at one year. Conclusion Patients who are treated with bisphosphonates during the three-year period before shoulder arthroplasty have a greater risk of intraoperative and one-year postoperative complications compared with those without this previous treatment.

Download Full-text

The Role of Conservative Management in Treatment of Critical Limb Ischemia

10.22541/au.160682959.98137517/v1 ◽

2020 ◽

Author(s):

Sara Mohamed ◽

Deirdre C Mc Dermott ◽

Khalid Ahmed ◽

Veronica McInerney ◽

Linda Howard ◽

...

Keyword(s):

Conservative Management ◽

Critical Limb Ischemia ◽

Statistical Significance ◽

Phase 1 ◽

Limb Ischemia ◽

P Value ◽

High Morbidity ◽

Conservative Group ◽

Kaplan Meier ◽

One Year

Background: Revascularization has been considered the gold standard treatment for critical limb ischemia (CLI). Due to the high morbidity and mortality associated with intervention, evidence has emerged recently supporting the suitability of conservative management as a primary option to achieve amputation-free survival (AFS) in CLI patients even when revascularization is technically feasible. Methods: A prospective database of CLI patients was developed during pre-screening of patients for a phase 1 stem cell therapy clinical trial. The overall survival (OS) and AFS rates for patients treated with revascularization were compared to those treated conservatively. Statistical significance was set as p value < 0.05. OS and AFS for the two groups were estimated by Kaplan-Meier survival curves. Results: Patients in the conservative group were more likely to have Rutherford Class 5 and be diabetic while they were less likely to be active smokers or have hyperlipidemia (Table 1). There were no significant differences between the two groups in mortality, amputation, overall AFS or one-year AFS rates. Kaplan-Meier cumulative OS and AFS over the 3 years follow-up period of the study demonstrated significant differences between the conservative and revascularization groups (Log Rank: 0.031 & 0.045; respectively). This statistical significance was not detected when one-year AFS was evaluated (Log Rank 0.096). Conclusion: Conservative management can be a suitable management option to achieve one-year AFS for some CLI patients. Further studies are needed to identify robust clinical criteria for identifying patients who will benefit from conservative management.

Download Full-text

Neuroleptic Malignant Syndrome: A Pilot Study on Psychiatric Inpatients in Iran

Current Psychopharmacologye ◽

10.2174/2211556008666191004121352 ◽

2019 ◽

Vol 8 (3) ◽

pp. 207-212

Author(s):

Saeed S. Shafti ◽

Alireza Memarie ◽

Masomeh Rezaie ◽

Masomeh Hamidi

Keyword(s):

Neuroleptic Malignant Syndrome ◽

First Generation ◽

Second Generation ◽

Psychiatric Patients ◽

Statistical Significance ◽

P Value ◽

Antipsychotic Treatment ◽

Second Generation Antipsychotics ◽

Significant Difference ◽

Male Patients

Background: Neuroleptic malignant syndrome is a life-threatening complication that can occur anytime during antipsychotic treatment. Objective: The present assessment has probed the incidence and clinical profile of neuroleptic malignant syndrome among a sample of non-western psychiatric patients and compared with the available data in the literature with regard to prevalence and other associated clinical physiognomies. Methods: As a retrospective, record-based evaluation, all cases with diagnosis of neuroleptic malignant syndrome during the last sixty-two months, after ruling out other imaginable differential diagnoses, like encephalitis, meningitis and serotonin syndrome, entered the present investigation. Clinical diagnosis, was in essence also based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. The assessment of independent variables was analyzed by ‘Compression of proportions’. Statistical significance is, defined as p value ≤0.05. Results: Among 19814 psychiatric patients, during a sixty-two months’ period, eighteen cases received the diagnosis of neuroleptic malignant syndrome. The most prevalent symptom was fever, which was observed in 100% of cases. Also, there was no significant difference between the first generation versus second-generation antipsychotics. Neuroleptic malignant syndrome was meaningfully more prevalent among male patients suffering from schizophrenia. Similarly, it was significantly more widespread amid 18-65 years old agegroup. Conclusion: While no significant difference was found between first-generation as opposed to second-generation antipsychotics, neuroleptic malignant syndrome was significantly more prevalent among young and male patients suffering from schizophrenia.

Download Full-text

Prevalence and Correlates of Aggression and Hostility in Hospitalized Schizophrenic Patients

Journal of Interpersonal Violence ◽

10.1177/0886260515585537 ◽

2016 ◽

Vol 32 (2) ◽

pp. 151-163 ◽

Cited By ~ 8

Author(s):

Vladimir Knezevic ◽

Dragan Mitrovic ◽

Svetlana Drezgic-Vukic ◽

Jelena Knezevic ◽

Aleksandar Ivezic ◽

...

Keyword(s):

Clinical Characteristics ◽

Demographic Variables ◽

Diagnostic And Statistical Manual ◽

Duration Of Illness ◽

Syndrome Scale ◽

Demographic Correlates ◽

Schizophrenic Patients ◽

Time Of Presentation ◽

Negative Syndrome ◽

Overt Aggression Scale

This study is aimed at identifying the incidence as well as clinical and socio-demographic correlates of aggression in hospitalized schizophrenic patients. We prospectively recruited participants with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnosis of schizophrenia presenting to the Clinic for Psychiatry during a 2-year period. We used the Modified Overt Aggression Scale to assess the aggression and Positive and Negative Syndrome Scale (PANSS) to assess the clinical characteristics of participants. One out of three patients with schizophrenia (31%) was aggressive and hostile at the time of presentation. Socio-demographic variables (such as gender, age, duration of illness, and number of hospitalizations) were poor predictors of aggression for schizophrenic patients. The level of aggression was not associated with the clinical characteristics in aggressive and hostile hospitalized schizophrenic patients. However, there was a weak negative association between the level of aggression and the PANSS Negative Scale ( p < .01). In conclusion, socio-demographic variables and clinical characteristics seem to be not such good predictors of aggressive behavior in hospitalized schizophrenic patients. Nevertheless, the results of our study contribute to the understanding of the prediction and treatment of aggression in a well-defined cohort of schizophrenic patients.

Download Full-text

Prolactin responses to im haloperidol in drug-naive and drug-experienced schizophrenic patients

European Psychiatry ◽

10.1017/s0924933800001814 ◽

1994 ◽

Vol 9 (2) ◽

pp. 91-94 ◽

Cited By ~ 3

Author(s):

M Markianos ◽

A Botsis ◽

J Hatzimanolis ◽

C Stefanis

Keyword(s):

Drug Treatment ◽

Clinical Response ◽

Dopamine Receptors ◽

Free State ◽

Neuroleptic Treatment ◽

Schizophrenic Patients ◽

Drug Naïve ◽

Male Patients ◽

One Year ◽

Drug Free

SummaryThe prolactin (PRL) responses to 5 mg im haloperidol were assessed in the drug-free state and after one month treatment with neuroleptics in 14 male schizophrenic patients who had never received drug treatment, and in 20 male patients who had discontinued their neuroleptic treatment for periods of two months to one year. Drug experienced patients showed lower PRL increases after acute haloperidol (mean 31.7 ng/ml) than drug-naive patients (mean responses 43.4 ng/ml). After treatment with neuroleptics in doses appropriate for the best clinical response, the baseline PRL levels were similar in the two groups, and im haloperidol did not cause any further PRL increases. The results provide evidence that after discontinuation of neuroleptics, the hypothalamic-pituitary dopamine receptors are subsensitive, and remain in that state for long periods of time.

Download Full-text

The Comparison of Olanzapine and Risperidone Treatment in Male Schizophrenic Patients using Positive and Negative Syndromes Scale (PANSS)

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.153 ◽

2018 ◽

Vol 6 (4) ◽

pp. 638-642 ◽

Cited By ~ 2

Author(s):

Endah Tri Lestari ◽

Elmeida Effendy ◽

Mustafa Mahmud Amin ◽

Bahagia Bahagia Loebis

Keyword(s):

Male Patient ◽

Inpatient Treatment ◽

Mental Hospital ◽

Atypical Antipsychotics ◽

P Value ◽

Post Test ◽

Schizophrenic Patients ◽

Patient Groups ◽

Male Patients ◽

Risperidone Treatment

INTRODUCTION: The most common method to compare olanzapine and risperidone is by calculating the score of positive and negative syndromes scale (PANSS). However, there were some conflicting results mentioned from previous studies.AIM: This study aimed to compare the treatment of olanzapine and risperidone using PANSS, limited to only male patients receiving inpatient treatment to obtain more significant results.METHODS: The subjects of this study were male schizophrenic patients in the acute phase of treatment (N = 68) who were hospitalised at the Mental Hospital Prof. Dr M. Ildrem, Indonesia. These participants were divided into two groups and treated with different atypical antipsychotics (olanzapine, 20 mg/day [n = 34]; risperidone, 6 mg/day [n = 34]). The scores of PANSS from both groups were collected from pre-test and post-test after 6 -week treatment.RESULTS: The improvement of the schizophrenia symptoms measured by PANSS after 6 weeks showed significant differences in the scores of PANSS between the male patient groups treated with olanzapine and risperidone (p-value < 0.001).CONCLUSION: The group of olanzapine shows a higher improvement of the scores of PANSS than that the group of risperidone.

Download Full-text

Acne: modern approaches to solving an old problem

Vestnik dermatologii i venerologii ◽

10.25208/vdv1170-2020-96-5-31-38 ◽

2020 ◽

Vol 96 (5) ◽

pp. 31-38

Author(s):

Z. Z. Kardashova ◽

I. A. Vasilenko ◽

E. V. Rusanova ◽

V. V. Schelkova

Keyword(s):

Clinical Symptoms ◽

Platelet Rich Plasma ◽

Statistical Significance ◽

Integrated Approach ◽

Therapeutic Effects ◽

Outpatient Basis ◽

Bacteriophage Therapy ◽

Acne Therapy ◽

Student’S T ◽

One Year

Background. Acne is one of the most common chronic dermatoses, which occurs in almost 8590% of the population. The disease manifests itself as polymorphic eruptions and is characterized by a recurrent and torpid course. Acne treatment is constantly improving, requires an integrated approach and long courses of therapy. Aims. To increase the effectiveness of acne therapy using new opportunities and promising methodological approaches using a combination of the therapeutic effects of platelet-rich plasma (PRP) and topical bacteriophage therapy. Materials and methods. The study included 30 patients with papulopustular acne of mild and moderate severity. Patients with mild acne were treated with PRP procedures as monotherapy. For moderate acne, PRP therapy was combined with regular applications of a staphylococcal bacteriophage (NPO Microgen, Nizhny Novgorod, Russia). The treatment was carried out on an outpatient basis: at least 3 procedures with an interval of 12 weeks (up to a maximum of 6 procedures within one year). The results were analyzed using descriptive statistics and the parametric Student's t-test. Data processing was carried out using the Biostat software. The value of the level of statistical significance of differences was taken as p 0.05. Results. Evaluation of the effectiveness of treatment was carried out on the basis of an analysis of the immediate outcomes of the disease, the dynamics of clinical symptoms and the severity of acne: regression of inflammatory elements of acne, a decrease in the phenomenon of seborrhea, improvement of the skin relief. As a result of the therapy, a transition to remission was noted in 16.6% of patients, an improvement in their condition 36.7%, a significant improvement 46.7%. Conclusions. An integrated approach combining PRP procedures and bacteriophage therapy can serve as a pathogenetically substantiated strategy for treating acne. A promising direction for further research is the development of new regimens and combinations of alternative therapeutic strategies using bacteriophages.

Download Full-text

Management of penile emergencies- one year observation

International Surgery Journal ◽

10.18203/2349-2902.isj20211803 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1413

Author(s):

Ashok Kumar Sarker ◽

Tarafdar Habibullah Babu ◽

Abul Bashar Shahriar Ahmed

Keyword(s):

Erectile Function ◽

Surgical Intervention ◽

Statistical Significance ◽

Sampling Technique ◽

P Value ◽

Shunt Procedure ◽

Ischemic Priapism ◽

Sensitive Organ ◽

One Year ◽

Surgery Department

Background: Penis is a very sensitive organ and even minor injury or discomfort may cause a patient to seek emergency evaluation. Penile emergencies and their management often rely on the results of imaging examinations. But most of the time the traumatic emergencies require urgent exploration to ensure a fair outcome. Objective was to present different types of penile emergencies and to determine the overall outcome of their managements.Methods: It was an observational study conducted at surgery department of Enam Medical College and Hospital, for one year. All patients with penile emergencies were included by selective sampling technique. The main outcome variables were type of penile emergencies, etiology of trauma, grading of trauma, types of surgical intervention, postoperative erectile function. Data processing and analysis were done using SPSS v (23). Statistical significance was determined by Students t test for quantitative data.Results: Total 33 patients admitted with emergencies. 18 (54.5%) belonged to traumatic category, 10 (30%) belonged to infective and one patient (3%) belonged to vascular (ischemic priapism) and others consist of 4 (12%). 40% of trauma was of grade III variety. Seven were victim of sharp cut injury. One who presented with ischemic priapism after 3 days underwent emergency distal shunt procedure with an acceptable functional penis post operatively. Timing of surgical intervention was compared with erectile function on the basis of International Index of Erectile Function (IIEF). A p value <0.05 was considered to be significant.Conclusions: Penile emergencies require prompt, accurate diagnosis. Early surgical intervention can save the organ.

Download Full-text