scholarly journals Acute Poisoning among Patients Presenting to the Emergency Department of a Tertiary Care Center: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Sameer Thapa ◽  
Bishwa Raj Dawadi ◽  
Anup Raj Upreti

Introduction: Acute poisoning is a major global public health problem contributing to one of theleading causes for a visit to an emergency department. This study aims to analyse the demographicand psychosocial characteristics of patients with acute poisoning presented to the emergencydepartment. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital fromJune to December 2019 after obtaining ethical approval from Institutional review board (referencenumber. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, typesof poison consumed, reason, motive, and place to take poison, time elapse in the presentation to thehospital were studied. Statistical analysis was done using statistical package for the social sciencesversion 20. Point estimate at 95% Confidence Interval was calculated along with frequency andproportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%) followedby unknown 12 (15.8). Of total, 28 (36.8%) had quarrel before taking poison and 41 (53.9 %) hadintention to commit suicide. Sixty-seven (88.2%) took a poison at home. The average elapsed time tothe visit of the emergency department was 110±80 minutes.   Conclusions: The most common poisoning was organophosphorus with a suicide being the mostcommon intention. Quarrel was the most frequent reason to take poison and the home was the mostcommon place to take poison.

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Anmol Purna Shrestha ◽  
Roshana Shrestha ◽  
Sanu Krishna Shrestha ◽  
Alok Pradhan ◽  
Samjhana Basnet

Introduction: Dyspnea is a common presenting complaint in the emergency department worldwide and a diagnostic challenge for emergency physicians. Our study aims to find the prevalence of dyspnea among patients attending emergency department in our hospital. Methods: A descriptive cross-sectional study was conducted in the emergency department of Dhulikhel hospital from May 2019 to July 2019 after ethical approval from the institutional review committee. Total 1200 samples were collected by consecutive sampling method. All patients were triaged in the emergency department as a part of regular protocol. The participants were included in the study after obtaining an informed consent from the patient or caretaker (if the patient were not able to provide it). Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. The statistical analysis was done using R version 3.5.3 (2019-03-11). Results: The prevalence of dyspnea among patients attending emergency department of a tertiary care hospital was 107 (8.9%) (4.6%-13.2%) at 95% confidence interval. The patients triaged into red, orange and yellow categories were 14 (13.1%), 50 (46.7%) and 43 (40.2%) respectively. Median age was 64 years and 74 (69%) were ≥60 years. Sixty-seven (62.6%) were females and 40 (37.4%) were males. Forty-four (41.1%) arrived by ambulance. Most commonly associated symptoms were cough and fever 59 (51.1%) and 44 (41.1%) respectively. Conclusions: The prevalence of dyspnea among patients attending emergency department of our hospital is higher compared to that of other studies. This warrants structured and prompt management of dyspnea for quality improvement.


2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Beena Jha ◽  
Manisha Sharma ◽  
Sagar GC ◽  
Jyotshna Sapkota

Introduction: Onychomycosis is a fungal disease of the nail apparatus caused by dermatophytes, non-dermatophytes and yeasts. Although onychomycosis is rarely life threatening, its high incidence and the associated morbidity makes it an important public health problem. This study was aimed to find the prevalence of onychomycosis among clinically suspected patients attending the outpatient department of Dermatology and Venereology. Methods: A descriptive cross-sectional study was done in a total of 200 clinically suspected cases of onychomycosis attending the Dermatology outpatient department of a tertiary care hospital within the period of one year from 1st September 2019 to 31st August 2020. Ethical approval (Reference: 150320196) was taken and convenience sampling was done. Data were analyzed using Statistical Package for Social Sciences version 19. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 200 clinically suspected cases prevalence of onychomycosis was found to be 40 (20%) (Confidence Interval = 19.94-20.06) by both direct microscopy and culture. Onychomycosis was commonest among age group of 21-40 years and more predominant among male patients 60 (65.21%). The fingernails were frequently involved i.e., 58 (63%) cases followed by toenails 34 (21%). Dermatophytes were the most common type of fungal infection accounting for 25 (62.5%). Conclusions: The study highlighted dermatophytes as the most common clinical pattern of onychomycosis and Trichophyton rubrum as the most common aetiological agent causing onychomycosis.


2021 ◽  
Vol 59 (244) ◽  
pp. 1267-1271
Author(s):  
Rajesh Kumar Shah ◽  
Sidarth Timsinha ◽  
Sanjib Kumar Sah

Introduction: Acute pesticide poisoning is a significant global public health issue that contributes to one of the leading causes of emergency department visits. There is no national data on the incidence of acute pesticide poisoning or the pesticides that cause deaths. The purpose of this study is to find the prevalence of pesticide poisoning among patients who presented to the emergency department with acute poisoning. Methods: This was a descriptive cross-sectional study undertaken in a tertiary care hospital from April to September 2021 among patients who presented to the emergency department with acute poisoning. Ethical clearance was obtained from (reference number: 123/2077-78). Convenient sampling was done. Sociodemographic factors, types of poison consumed, route of consumption, reason, motive, and place of poison intake, time elapse in the presentation to the hospital were studied along with psychological factors associated with poisoning. Statistical analysis was done using Statistical Package for the Social Sciences version 23. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 85 cases studied, the prevalence of pesticide poisoning was 60 (70.58%) (61.28-79.88 at 90% Confidence Interval). Insecticides 41 (68.33%) was mainly responsible for poisoning with organophosphate compounds 33 (42.30%), being the commonest chemical constituent. Fifty-three (88.33 %) incidents occurred at home. Domestic disputes 26 (43.33%) were the main reason behind poison consumption and suicide 43 (71.66%) was the main motive. Conclusions: The prevalence of pesticide poisoning among all cases of poisoning presenting to the emergency department was slightly higher than studies done earlier in similar settings.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel

Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.


2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Deepak Regmi ◽  
Rachana Baidhya ◽  
Ashik Rajak ◽  
Nain Bahadur Mahato ◽  
Sangita Shrestha ◽  
...  

Introduction: Zuckerkandl tubercle is a prominent anatomical structure of the thyroid lobe. Identification and preservation of recurrent laryngeal nerve and parathyroid glands during thyroid surgery can be made easier through assessment of their relationship with the Zuckerkandl tubercle. This study aims to determine the anatomical relationship between Zuckerkandl tubercle and superior parathyroid in patients who underwent thyroidectomy in a tertiary care center. Methods: This descriptive cross-sectional study was conducted at a tertiary care hospital of Nepal following ethical clearance from the Institutional Review Committee (Reference no: 0106201804) among patients who underwent thyroid surgery between July 2018 to February 2020. Convenience sampling was used for collecting data and was entered in Statistical Package for the Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency andproportion for binary data. Results: Out of 59 cases, 27 (96.4%) of superior parathyroid on the left were at the 1-2 o’clock position, and 28 (90.3%) of superior parathyroid on the right were at 10-11 o’clock position. On the left side, the superior parathyroid was adhered to Zuckerkandl tubercle in 10 (35.7%), was within 5 mm in 16 (57.1%), and was >5 mm away from Zuckerkandl tubercle in 2 (7.14%). On the right side, the superior parathyroid was adhered to Zuckerkandl tubercle in 12 (38.7%), was within 5 mm in 13 (41.93%), and was >5 mm away from Zuckerkandl tubercle in 6 (19.3%). Conclusions: Zuckerkandl tubercle has a consistent relationship with the superior parathyroid and can be used as an important landmark for identifying superior parathyroid during thyroid surgery.


2020 ◽  
Vol 3 (1) ◽  
pp. 16-20
Author(s):  
P Shrestha ◽  
K Shrestha ◽  
L Acharya ◽  
S Shakya

Introduction: Sinew strings are frenum or wrinkle like entity of mandibular distal buccal mucosa which is frequently encountered in the population. Sinew strings play an important role in determining the width and buccal extension of the denture flange of mandibular complete denture. Materials and Methods: This descriptive cross-sectional study was conducted at a tertiary care hospital from 17th June 2020 to 20th September 2020. Convenient sampling (n=245) was done. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data analysis was done in Statistical Package for the Social Sciences version 21. Results: Among the study population (n=245 participants), sinew string was seen in 35% of the participants. The frequency of sinew string present bilaterally was 19% while it was present unilaterally in 16% of the population. Conclusions: The presence of sinew string in the sampled Nepalese population showed a higher prevalence than previous studies.  


2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Robin Joshi

Introduction: Retrograde intrarenal surgery with improving skill and knowledge may be consideredone of the first-line treatment options for removal of renal stones. The study is done to find theoutcome of retrograde intrarenal surgery in patients with renal stone. Methods: This descriptive cross sectional study was carried out on patients undergoingretrograde intrarenal surgery for renal stone at a tertiary care hospital December 2019 to March2020. Ethical approval was taken from the institutional review committee (Ref. no.200120202).The Convenient sampling method was applied. Data was collected and analyzed in StatisticalPackage for the Social Sciences version 20.0. Point estimate at 95% confidence interval wascalculated along with frequency and proportion for binary data. Results: Out of the 28 patients, the retrograde intrarenal surgery was successful in 27 (96.4%)cases. There were 16 (57.15%) females and 12 (42.86%) male patients with the mean age of37.86±11.47 years. Most of the stones were in renal pelvis 18 (64.28%) followed by lowercalyx 8 (28.57%). The mean diameter of the stone was 11.47 ±3.33mm whereas most ofthe stones were on the right side 16 (57.15%). The mean hardness was 1155.21±265.34Hounsfield units. Perioperative complications like failed access sheath placement in 2 (7.14%)cases, hematuria in 6 (21.43%) cases, fever in 6 (21.43%) cases, and septicemia in 4 (14.28%)cases. Conclusions: We found that the success rate of retrograde intrarenal surgery for the renal stonewas acceptable and similar to other published studies . Retrograde intrarenal surgery is feasiblefor the treatment of kidney stones with acceptable complications and success rates.


2020 ◽  
Vol 58 (224) ◽  
Author(s):  
Sanat Chalise ◽  
Ramesh Dhakhwa ◽  
Sailesh Bahadur Pradhan

Introduction: Skin diseases are much common in developing countries. The spectrum varies accordingto geographic distribution, gender, age, and coexisting disorder. We conducted this study to find outthe prevalence of different skin lesions and to evaluate their frequency and site of distribution. Methods: A descriptive cross-sectional study was done in the pathology department of KathmanduMedical college from June 2019 to November 2019 after ethical clearance. The skin biopsies wereprocessed, sectioned and stained with Haematoxylin and eosin and evaluated. A conveniencesampling method was used. Data was collected and entry was done in Statistical Packages for SocialServices version 20.0, point estimate at 95% Confidence Interval was calculated along with frequencyand proportion for binary data. Results: Among 133 skin biopsies examined, noninfectious vesicobullous and vesicopustulardisease were found in 42 (46.6%) cases followed by microbial disease in 22 (24.5%) and noninfectiouserythematous papular and squamous disease in 21 (23.4%) cases. Spongiotic dermatitis was themost common vesicobullous disease seen in 26 (28.9%) cases. Leprosy was the commonest microbialdisease found in 7 (7.8%) cases. The commonest noninfectious erythematous papular and squamousdisease was erythema dyschromicum perstans seen in 7 (7.8%) cases. The commonest neoplasticlesion was keratinocytic tumor seen in 12 (32.5%) cases. The commonest tumor of the skin wasintradermal nevus seen in 6 (16.3%) cases.  Conclusions: Spongiotic dermatitis is a predominating non-neoplastic and overall skin lesion whichwas similar to the other studies done. Histopathological examination is the gold standard for theproper diagnosis as histomorphological features distinguish various skin lesions.


2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Prekshya Thapa ◽  
Sami Lama ◽  
Nirmala Pradhan ◽  
Kriti Thapa ◽  
Rajesh Kumar ◽  
...  

Introduction: Understanding the attitude of caregivers towards suicide attempters could be useful in suicide prevention. The objective of this study was to study attitude towards suicide among caregivers of patients with suicide attempt admitted to a tertiary care hospital in Nepal. Methods: A descriptive cross-sectional study was conducted with 52 caregivers of patients with suicide attempt who had been admitted to a tertiary care hospital of Nepal after obtaining ethical clearance from Institutional Review Committee (ref. IRC/0797/016). Data were collected through interviews using the Attitude towards Suicide Questionnaire and in-depth interviews conducted on five caregivers using the interview framework developed in the department for the purpose. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Content analysis was used for qualitative data. Results: Majority of the caregivers 34 (65.4%) had unfavorable attitude towards suicide. Caregivers reported that mental and chronic physical illness, financial difficulty, working environment, and social factors such as undue pressure and failure to perform the task, difficulty maintaining the relationship, abuse, and neglect could be some of the possible causes of suicide. Caring and understanding attitude of family members, health professionals, and society towards the suicidal individuals providing appropriate training and education to the public would help in reducing the stigma and burden of suicidal patients. Conclusions: The overall attitude of the caregivers was unfavorable. Interventions targeted towards improving attitude towards suicide could be helpful in suicide prevention.


2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Anu Kushwaha ◽  
Khilasa Pokharel ◽  
Anuj Raj Kadel

Introduction: Urinary tract infection is treated by the antibiotic sensitivity pattern of uropathogensin our population. Present infection cases have been showing an increase in resistance to the currentfirst-line of antibiotics. The objective of this study is to determine the resistance of antibiotics inEscherichia coli in a tertiary care center. Methods: This is a descriptive cross-sectional study done in Kathmandu Medical College TeachingHospital from October 2018 to February 2019. The sample size was calculated, and convenientsampling was done. Patients with urine culture positive (i.e., Colony-forming unit >105) wereincluded in the study. All positive samples were tested for antibiotics sensitivity and resistance. Theresistance to the antibiotics was recorded using Statistical Package for Social Sciences version 20.Point estimate at 95% confidence interval was calculated along with frequency and proportion forbinary data. Results: Out of 100 samples, the highest number of organisms isolated was Escherichia coli, 71 (71%).Escherichia coli showed the highest resistance to drugs like Norfloxacin, 37 (52.11%), AmoxicillinClavulanic acid 37 (52.11%), followed by Co-trimoxazole 32 (45.1%), Ceftriaxone, 24 (33.8%), andCiprofloxacin 23 (32.3%). Conclusions: Escherichia coli showed the highest resistance to commonly used antibiotics likeNorfloxacin, Amoxicillin-Clavulanic acid, Co-trimoxazole, Ceftriaxone, and Ciprofloxacin.


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