scholarly journals Injury amongst Medicolegal Cases in Department of Forensic Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1277-1282
Author(s):  
Arbin Shakya ◽  
Jenash Acharya ◽  
Sunil Joshi

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases inthe Department of Forensic Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done amongst 328 medicolegal cases presenting at a tertiary center, from January 2019 to February 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 2603202101). Convenience sampling was used to select study samples. After detailed history regarding the incidence, injuries were examined and documented in a performa. The data were entered in Statistical Package for Social Sciences version 18. Point estimate at 95% Confidence Interval was calculated along with frequency and percentagefor binary data. Results: Among 328 cases presenting to hospital for medicolegal issues, 237 (72.25%) (67.40-77.09 at 95% Confidence Interval) had injuries, out of which 170 (71.73%) cases were due to physical assault, 64 (27%) cases due to accident; 2 (1.26%) were undetermined. Majority of victims of injury were adult males, with mean age of 32.41±13.96 years. In most accidental injuries internal organs were also injuries and life-threatening. Conclusions: The prevalence of injuries amongst medicolegal cases was found to be higher in our study in comparison to other studies done in similar settings. Most of the injuries were due to physical assault; however, the majority of road traffic injuries were life-threatening. These road traffic injuries could have been prevented by following a safe system approach to road safety.

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035951
Author(s):  
Saja S Al-Otmy ◽  
Abeer Z Abduljabbar ◽  
Rajaa M Al-Raddadi ◽  
Fayssal Farahat

ObjectivesTo explore magnitude and factors associated with non-urgent visits to the emergency department (ED) in a tertiary care centre, western Saudi Arabia.DesignA cross-sectional study.SettingED of a tertiary care hospital in western Saudi Arabia.Participants400 patients, both men and women.InterventionsAn interview-based questionnaire was administered to a consecutive sample of patients who visited the ED during morning shifts, where primary healthcare centres (PHCs) and outpatient clinics were available.Primary outcome measureED visits classified as non-urgent versus urgent (excluding life-threatening conditions) based on the Canadian Triage and Acuity Scale (CTAS). Levels IV and V were classified as non-urgent.ResultsMajority of the cases were adult (97.3%) and half of them were women (54.8%). Non-urgent visits represented 78.5% among non-life-threatening cases. One-third of the patients (33.8%) had three visits or more to the ED during the past year. Main reasons for visiting the ED were perception that the condition was urgent (42.0%), easy access (25.5%) and limited resources and services at the PHCs (17.8%). Patients 40–50 years old were more likely to have non-urgent visits (OR=3.21, 95% CI 1.15 to 8.98). However, likelihood of non-urgent visits was significantly lower among patients with cancer (OR=0.37, 95% CI 0.19 to 0.72) and cardiovascular disease (OR=0.43, 95% CI 0.23 to 0.83), and those who live near the hospital (OR=0.49, 95% CI 0.28 to 0.88).ConclusionsThe current study reported overuse of the ED. Enhancement of the primary care services, in concordance with community awareness, is an important component to reduce burden due to non-urgent use of the ED.


2021 ◽  
Vol 59 (241) ◽  
pp. 844-847
Author(s):  
Anamika Jha ◽  
Anugya Sah ◽  
Birendra Raj Joshi ◽  
Benu Lohani

Introduction: Breast arterial calcifications are common mammographic findings which are associated with coronary artery disease. The aim of this study was to find the prevalence of breast arterial calcifications in women presenting for mammography in a tertiary care centre. Methods: This descriptive cross-sectional study was performed in the Department of Radiology, in a tertiary care hospital after taking ethical clearance, Reference number 352(6-11)E-2, 077/078, data was collected from Syngovia database from March-June 2021 which included 1614 mammograms. Convenience sampling was done and mammograms evaluated for presence of vascular or non-vascular calcification. Further, vascular calcification was graded. Data was entered in Statistical Package for Social Sciences version 25. Point estimate at 95% Confidence Interval was done, and frequency and proportion were calculated. Results: The prevalence of breast arterial calcification was 188 (11.6%) at 95% Confidence Interval (10.03-13.2). The mean age of women included in this study was 48.42±9.55 years with the largest number of patients in the age group 40-49 years, 682 (42.3%), and least in the age group 80-89 years, 3 (0.2%). All patients in the age group 80-89 years, 3 (100%) had vascular calcifications followed by 70-79 years group, 22 (57.5%) and none in patients younger than 30 years. Conclusions: We found an increase in the number and grade of vascular calcifications in breasts with the patient's age. When present breast arterial calcifications must be mentioned in mammogram report. Identification of such calcifications on mammogram should prompt further screening for atherosclerotic disease.


2021 ◽  
Vol 59 (241) ◽  
pp. 833-838
Author(s):  
Abhishek Bhandari ◽  
Prashant Shah ◽  
Naveen Kumar Pandey ◽  
Richa Nepal ◽  
Ojaswee Sherchand

Introduction: Anaemia is an important comorbidity common in patients with heart failure and is associated with poor clinical status and worse outcomes. In Nepal few studies have evaluated anaemia amongst patients suffering from heart failure. We intended to find out the prevalence of anaemia in patients with heart failure in a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among patients of heart failure presenting to tertiary care hospital in eastern Nepal from April 2017 to January 2018. Ethical approval was taken from the Institutional Review Committee of a tertiary care centre (reference number: IRC/0842/016). Using the convenience sampling method, 100 patients were enrolled in the study. Blood samples from the patients were taken for haemoglobin and serum iron studies. Data was analysed using Statistical Package for Social Sciences version 11. Point estimate at 95% Confidence Interval was calculated, with frequency and percentage. Results: Among 100 patients with heart failure, 82 (82%) (74.47-89.53 at 95% Confidence Interval) had anaemia. Mean haemoglobin level of the study population was 10.40±2.73 g/dl. Fifty four (54%) of patients had iron deficiency status irrespective of presence or absence of anaemia. Conclusions: Prevalence of anaemia among patients of heart failure in our study was found to be higher than various other homologous international studies.


2021 ◽  
Vol 59 (241) ◽  
pp. 853-857
Author(s):  
Nisha Sharma ◽  
Bibechan Thapa ◽  
Ashirbad Acharya ◽  
Bijendra Raj Raghubanshi

Introduction: Antimicrobial-resistant Acinetobacter species are implicated in a variety of infections including nosocomial bacteraemia, secondary meningitis, and urinary tract infections. Carbapenem including meropenem-resistant Acinetobacter is recognized as one of the most difficult antimicrobial resistant gram-negative bacilli to control and treat. It was classified as an urgent threat by Centers for Disease Control and Prevention in 2019 Antibiotic Resistance Threats Report. This study was carriedout to determine the prevalence of meropenem resistance among acinetobacter positive clinical samples in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out in microbiology department of Clinical Laboratory Services among Acinetobacter positive clinical samples of a tertiary care center in Nepal. The culture and sensitivity reports of various clinical samples from April 2018 to April 2020 which were positive for Acinetobacter species were taken from hospital records section. Convenience sampling was done. Meropenem-resistant Acinetobacter samples were studied. Ethical approval was received from Institutional Review Committee (Ref No. 076/77/40). Analysis of data was done using Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval calculated with ferquency. Results: Out of 121 Acinetobacter isolates, prevalence of meropenem-resistant Acinetobacter was reported in 93 (76.9%) at 95% Confidence Interval (69.39-84.40). Among the meropenem-resistant Acinetobacter samples, most of the samples were collected from the sputum 70 (75.2%) followed by blood 8 (8.6%). Conclusions: High prevalence of meropenem-resistant Acinetobacter species in our hospital setting is alarming. In addition, there is emergence of resistance against even the last resort drugs which is creating a treatment crisis.


2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Neebha Ojha ◽  
Meena Jha ◽  
Eliza Shrestha ◽  
Ganesh Dangal

Introduction: Cervical cancer is the leading gynaecological cancer in Nepal. Most of the time, it is diagnosed in the late stage with its associated morbidity and mortality. This study aimed to find out the prevalence of late-stage presentation of cervical cancer among confirmed cases of cervical cancer in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted at a tertiary care centre of Nepal from March 2021 to May 2021 after obtaining ethical clearance from the Institutional Review Board (Reference no.805). A convenient sampling method was used. A descriptive analysis was done of all cases of cervical cancer who were diagnosed within the last 36 months and attended hospital during the study period. The information was collected by interview and hospital record was checked. Analysis was done using Statistical Package for Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among the 142 confirmed cervical cancer cases, the prevalence of late-stage presentation of cervical cancer was 93 (65.5%) (57.7-73.3 at 95% Confidence Interval). The mean age at diagnosis was 50.6±10.9 years. More than two-thirds of the women were from outside Kathmandu valley 102 (71.8%) and came from >50km distance. The majority of the women 83 (58.5%) were illiterate. Conclusions: The study showed that two-thirds of the women presented in advanced stage and the factors leading to the late stage. This highlights the fact, that the focus should be on the provision of organized screening programs and early diagnosis and treatment of cervical cancer.


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