scholarly journals The Menopausal Symptoms of Paramedics at a Tertiary Care Center

Author(s):  
Toar A Kumaat ◽  
Maria F T Loho ◽  
Eddy Suparman

Objective: To assess paramedic menopausal symptoms on theinpatient unit and outpatient unit.Methods: This was a cross sectional study. Data collect by fill thequestioner, the questioner fill by menopausal paramedic on Prof. Dr.R. D. Kandou Manado Hospital from October 2016 to January 2017.Data were analyzed using SPSS 22.0 for Windows.Results: Of 60 paramedics, 30 were divided to inpatient unit andthe other 30 were divided to outpatient unit. By the menopauserating scale, somatic and urogenital complaint in statistical testhave no significant differences. Psychology complaint with a moderatecomplaints on inpatient unit have 19 paramedic (63%) and12 paramedic (40%) on outpatient paramedic, in statistical havea significant differences (x2=9.62, p=0.022). On the total scoremenopausal complaints, the moderate complaints 18 paramedic(60%) on the inpatient unit and the minor complaints 21 paramedic(70%) on the outpatient unit, in statistical have a significantdifferences (x2=6.97, p=0.031).Conclusion: There is no significant difference in somatic andurogenital complaints on paramedic inpatient unit and outpatientunit. There is a significant difference in psychological complaintsand total score menopausal complaints on paramedic inpatientunit and outpatient unit.[Indones J Obstet Gynecol 2017; 5-4: 208-212]Keywords: menopause, menopause rating scale, paramedic

Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 


2018 ◽  
Vol 5 (2) ◽  
pp. 19-26
Author(s):  
Praveen Bhattarai ◽  
Devavrat Joshi

Background and Objectives: Delirium is one of the most important neuro-psychiatric disorders in Consultation liaison psychiatry. There is a dearth of studies in this subject in Nepalese context. The objective of this study was to find out the demographic profile, source of referral, reason for referral and possible risk factors for delirium and association between risk factors and subtypes of delirium.Material and Methods: This is a descriptive cross-sectional study carried out in a tertiary care center over a period of six months. Delirium was diagnosed by psychiatrist based on International Classification of Disease, 10th revision, Diagnostic Criteria for Research (ICD-10 DCR) and was classified into subtypes using the Liptzin and Levkoff criteria. Data analysis was done using SPSS version 16 and chi- square test was applied to find the association between risk factors and subtypes of delirium.Results: A total of 52 cases of delirium were included in the study. Majority of cases were aged 65 years and above with male preponderance. The most common cause for referral was disturbed behavior and disorientation. Hyperactive delirium was the most common subtype of delirium. Most of the referred cases of delirium were from Medical ward and Intensive Care Unit/Critical Care Unit (ICU/CCU). Infection / Inflammation, Drug/alcohol intoxication or withdrawal and those with multiple etiologies were the most common possible causes of delirium. There was no significant difference in terms of associated risk factors between the clinical subtype (p = 0.8023).Conclusion: The presence of delirium warrants prompt intervention to identify and treat the underlying causes and consultation liaison psychiatric services should be enhanced to achieve this goal.Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 19-26


Author(s):  
Geetika Syal ◽  
Neha Mohindroo ◽  
Anshul Rana ◽  
Rita Mittal

Background: Identifying and measuring menopausal symptoms using Greene Climacteric Scale and calculating the mean age at menopause to find out the frequency of the menopausal symptoms so that can be used for better perimenapausal and menopausal care to females.Methods: A cross-sectional study was conducted in a tertiary care center in northern India. All menopausal women in gynaecology outpatient department were enrolled in study, over six months from May 2019 to October 2019. A total of 206 women fulfilled the inclusion criteria and were interviewed using the 21 points Greene Climateric Scale (GCS) Questionnaire. Analysis was done using SPSS 20 Windows software. Descriptive statistics included computation of percentages, means and standard deviations. Level of significance was set at P≤0.05.Results: The mean age of menopause was 47.9±3.42 years. About 90.3% of the menopausal women studied belonged to the rural population. The most frequently perceived symptoms by females were muscle joint pain (100%), vaginal dryness and pruritus vulvae (84%), lower abdominal pain (79.6%), hot flushes (50.5%).The most frequently reported symptoms as per the GCS were muscle and joint pains, loss of interest in sex, headaches, feeling tired or lacking in energy, difficulty in concentrating, attacks of anxiety, difficulty in sleeping and hot flushes. The mean total score was 17.61.Conclusions: Menopausal symptoms were common in this study group but women seeking help for the same was less. Therefore menopause clinics and care programmes need to be developed and strengthened to promote better health and higher quality of life in menopausal women.


2012 ◽  
Vol 70 (11) ◽  
pp. 843-846 ◽  
Author(s):  
Hugo Morales-Briceño ◽  
Amin Cervantes-Arriaga ◽  
Mayela Rodríguez-Violante ◽  
Juan Calleja-Castillo ◽  
Teresa Corona

Underweight and malnutrition are well documented in Parkinson's disease (PD), while overweight has been less reported. We carried out a cross-sectional study including 177 healthy controls and 177 PD patients attending a tertiary care center. We recorded weight and height for all participants. A statistically significant difference was found in body mass index (BMI) between controls and PD patients (29.1±5.4 versus 27.2±4.7, p<0.001). In the PD Group, two patients were underweight, 32.7% were within normal range, 46.9% had overweight, and 19.2% were obese. Overweight and normal weight were more prevalent in the PD Group (p=<0.01 and <0.001, respectively) when compared to controls. In conclusion, overweight/obesity are common among patients with PD, while underweight is almost negligible.


2019 ◽  
Vol 48 (2) ◽  
pp. 030006051987349
Author(s):  
Witchuwan Onsoi ◽  
Jitjira Chaiyarit ◽  
Leelawadee Techasatian

Objectives Dermatological disorders are common in general pediatric practice. This study aimed to examine common skin problems and the manner in which they tend to be misdiagnosed. Methods A cross-sectional study was conducted from January 2015 to December 2016 using medical record data from the Pediatric Dermatological Outpatient Unit at Khon Kaen University, Faculty of Medicine. Results A total of 1551 visits by 769 patients were documented during the study period. A total of 114 presenting diseases were recorded. The most common skin disease in the study population was dermatitis (unspecified) (88/769, 11.4%), followed by atopic dermatitis (76/769, 9.8%) and infantile hemangioma (72/769, 9.3%). There was a total of 55 (48.2%) misdiagnosed diseases. Some unique cutaneous diseases were undiagnosed because of their rarity. However, the percentages of common cutaneous diseases, such as tinea capitis and molluscum contagiosum, which had been misdiagnosed, were also high (62.50% [95% confidence interval = 24.49–91.48] and 71.43% [95% confidence interval = 29.04–96.33], respectively). Conclusion A large percentage of misdiagnoses of common cutaneous diseases may be due to general pediatricians being undereducated in the field of dermatology. Accurate recognition and appropriate management of these conditions should be emphasized for educating general pediatricians in the future.


2017 ◽  
Vol 24 (06) ◽  
pp. 904-911
Author(s):  
Syed Rizwan Ali Bokhari ◽  
Syed Arsalan Khalid ◽  
Nida Nadeem ◽  
Sidra Saleem ◽  
Zumar Sardar ◽  
...  

Background: Acute kidney injury (AKI) in pregnant women is commonly seen indeveloping countries. It is associated with significant morbidity, social and personal implications.We conducted a study to assess the prevalence and severity of depression in patients withpregnancy related AKI (PRAKI) in a tertiary care center. Methodology: Patients with PRAKIadmitted from 1-16 to 6-16 under Nephrology service, Jinnah Hospital, Lahore were included inthis cross-sectional study. The Hamilton Rating scale for depression (HAM-D) version translatedand adapted in Urdu, was used to assess the study population. These patients were interviewedwith the HAM-D questionnaire on their first encounter with Nephrology department. Previoushistory of psychiatric illness was excluded. The diagnosis of AKI was based on the classificationof the Acute Kidney Injury Network group. Results: The mean age of the patients was 24±5years. Seventeen (57%) patients were multipara and 13(43%) patients were primigravida. Of the30 patients with AKI, 8 (27%) presented before 28 weeks and 22 (63%) presented after 28 weeksof gestation. The causes of AKI included postpartum hemorrhage in 9 (30%), sepsis in 8 (27%),preeclampsia/eclampsia in 6(20%), shock in 4 (13%) and coagulopathy in 3 (10%) patients.Alive and healthy fetus was found in only 15 (50%) patients. Twenty-one (70%) patients receivedaverage of 5-8 hemodialysis sessions during their hospital stay. Twenty-three (76%) had nodepression (0-7 score), 2 (7%) had mild (8-13 score), 3 (10%) had moderate (14-18 score) and2 (7%) had severe (19-22 score) depression according to HAM-D score. Conclusions: Ourstudy depicted considerable depression of varying degrees in women with PRAKI, increasedawareness and effective monitoring for depression should be integrated into regular maternalcare to decrease morbidity associated with it.


2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Asmita Pandey ◽  
Chanda Karki ◽  
Veena Rani Shrivastava ◽  
Dipty Shrestha ◽  
Pratigyan Gautam

Introduction: Menopause is the permanent cessation of menstruation for more than a year resulting from the loss of follicular activity of the ovaries. It is manifested by vasomotor, psychological, and urogenital symptoms which can be assessed by an internationally accepted scale known as Menopause Rating Scale. This study was conducted to find out the issues of perimenopausal women and proceed for management and proper counseling. Methods: A descriptive cross-sectional study was conducted among women visiting the gynecological outpatient department of a tertiary care hospital from June 2017 to May 2018 using the Menopause Rating Scale. Ethical approval was taken from the Institutional Review Committee (reference number: 20122016). Convenient sampling was done. Statistical Package for the Social Sciences version 20.0 was used for data analysis. Point estimate at 90% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of 189 perimenopausal women interviewed, the mean age of menopause was found to be 50.2±2.1 years. The most common gynecological symptoms among the study population was abnormal uterine bleeding 66 (34.9%) followed by abnormal vaginal discharge 50 (26.5%). Among symptoms in Menopause Rating Scale, the depressive mood was found in 99 (52.4%) cases followed by joint and muscular discomfort 88 (46.6%) and bladder problems in 87 (46%). None of the women had a score on the Menopause Rating Scale more than 16 and did not require management for their problem. Conclusions: Most of the women didn't know menopausal symptoms. However, none required intervention from gynecologists for their problems reflecting better quality of life.


2017 ◽  
Vol 8 (2) ◽  
pp. 44-49
Author(s):  
Iyshwarya Udaya Kumar ◽  
Jaya Prakash Murthy ◽  
Ujwal Upadya ◽  
Mahesh Venkatesh

Background: Diabetes Mellitus is a chronic disorder, which is becoming rapidly epidemic in India.There are many complications occur due to uncontrolled diabetes mellitus.The outcome of diabetes depends mainly on the patient’s self-management like health-related behavior, which is based on his or her knowledge. Awareness on diabetes mellitus is still a lacunae among the Indian population.Aims and Objective: To determine the knowledge regarding awareness of diabetes like the risk factors, symptoms, complications and the management among the males and females in rural population.Materials and Methods: It is a cross sectional study conducted at the tertiary care center in rural Bangalore. A structured questionnaire was used and 300 adults were assessed on their knowledge regarding the awareness of diabetes.Result: Out of 300 adults, 159 adults (53%) had a history of diabetes. There was no gender difference observed regarding the awareness, nor the education played a role. There was significant difference observed in knowledge of diabetes Mellitus among the diabetics with respect to renal complications (p <0.013), symptoms like blurring of vision (p < 0.043) and burning feet (p < 0.009).Conclusion: Both the diabetic and non-diabetic groups had very low awareness regarding diabetes and associated risk factors. Both Males and females awareness levels were poor. Proper Diabetic education programme will help in raising public awareness of the disease.Asian Journal of Medical Sciences Vol.8(2) 2017 44-49


2020 ◽  
Vol 58 (228) ◽  
Author(s):  
Archana Tiwari ◽  
Ramji Rai ◽  
Prahar Dahal ◽  
Sudeep Regmi

Introduction: Presence and severity of Helicobacter pylori (H. pylori) colonization is an important factor to decide the treatment of chronic gastritis. This study aimed to find the prevalence of H. pylori colonization in chronic gastritis patients. Methods: This descriptive,cross-sectional study was carried out at the tertiary care center in the the western region of Nepal among the dyspeptic patients undergoing endoscopic gastric biopsy from October 2018 to March 2020 after approval from the Institutional review committee. Convenience sampling was done to reach the sample size. Two hundred fifty cases were included in the study. Data were recorded in proforma and Data analysis was done in the statistical package for social sciences (SPSS 16.0). The severity of H. pylori colonization and gastritis was graded using the Updated Sydney System. Results: All cases showed chronic gastritis on histopathology. H. pylori were seen in 150 (60%) of cases. Mild, moderate, and severe H. pylori infection was seen in 59, 78, and 13 cases respectively. Out of 59 mild H. pylori cases, 35 (59.32%) had mild chronic inflammation; out of 78 moderate H. pylori cases 51 (65.38%) had moderate chronic inflammation and among 13 severe H. pylori cases, 10 (76.92%) had severe chronic inflammation. Conclusions: Prevalence of H. pylori colonization is high in chronic gastritis and there is a parallel increase in the severity of gastritis with an increase in the severity of H. pylori load.


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