scholarly journals Changes in ECG among patients with drug induced poisoning in a tertiary care hospital

2019 ◽  
Vol 44 (3) ◽  
pp. 160-167 ◽  
Author(s):  
Ashraf Ur Rahman ◽  
AW Chowdhury ◽  
S Jabeen

Background: A wide variety of ECG changes can be seen with cardiac and noncardiac agents and may occur at therapeutic or toxic levels. Wide QRS and QT prolongation may be seen in poisoning cases; are potentially dangerous and indicate the necessity of continuous cardiac monitoring.The objective of this study was to determine the changes in ECG among patients admitted with pharmaceutical drug induced poisoning in a tertiary care hospital in Dhaka. Methods: This cross sectional study was carried out at the Department of Medicine, Dhaka Medical College Hospital (DMCH) during July-December, 2013. Detailed information were obtained; clinical examination and relevant investigations including ECG were done in each case according to protocol. Results: Among 66 cases mean age was 22.9 (±6.47) years and male to female ratio was 1: 2.14 (21 Vs 45). Common drug groups taken by the study population were benzodiazepines in 31(47.0%) and tricyclic antidepressants (TCA) in 18(27.3%) cases.Normal ECG findings were found in 28 (42.4%) cases, 18 (27.3%) cases revealed sinus tachycardia, 11(16.7%) showed prolong QT Interval, 6(9.1%) had atrial tachycardia, 5(7.6%) showed wide QRS and 3(4.6%) cases revealed prolong PR interval. Patients withTCA poisoning developedsinus tachycardia in 11(61.1%), prolong QT Interval in 6(33.3%), wide QRS in 5(27.8%),atrial tachycardia in 5(27.8%), prolong PR Interval in 2(11.1%), and Tall R in aVRin 2(11.1%) cases. Prolong QT Interval were found among 3 (75.0%) patients with K+ efflux channel blockers (chlorpromazine, chlorpheniramine and quetiapine) overdose.Patients with beta blocker overdose developed sinus bradycardia in 4 (100.0%) and prolong PR Interval in 1(25.0%) cases. Conclusion: Common drugs taken by the patients were amitriptyline sedatives. Wide QRS, prolong QT interval and some other ECG changes were observed by TCA poisoning in higher doses. TCA, benzodiazepines and K channel blockers induced prolong QT Interval in higher doses.Careful interpretation of ECG findings can provide key information to guide management of the poisoned patients. Bangladesh Med Res Counc Bull 2018; 44: 160-167

Author(s):  
Naveen Nagaraju ◽  
Puneetha .

<p class="abstract"><strong>Background:</strong> Cutaneous adverse drug reactions (CADR) are common yet important entity in dermatological clinical practice. This study is to investigate the clinical spectrum of CADR reactions and assess its causality relationship to offending drug.</p><p class="abstract"><strong>Methods:</strong> It was a cross-sectional observational study, conducted at a tertiary care hospital over a period of two years. Total of 200 patients with cutaneous drug rash diagnosed based on detailed history, correlation between drug intake and the onset of rash, thorough clinical examination and laboratory parameters were included and patients without details of drugs were excluded.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 200 cases, mean age was 33.57 years (6 months to 87 years). The commonest age group was 19-30 years (27%) and Male: female ratio was 0.94:1. The most common morphological pattern was maculopapular rash seen in 46 cases (23%), followed by FDE- 34 (17%), urticaria- 22 (11%), acneiform eruptions- 20 (10%), drug induced hyperpigmentation- 13 (6.5%), EMF- 12 (6%), lichenoid eruptions- 12 (6%), photosensitivity- 11 (5.5%), eczematous dermatitis- 6 (3%), pruritus- 6 (3%), angioedema- 6 (3%) and SJS- 6 (3%), DRESS- 2 (1%), TEN- 2 (1%), DHS and psoriasiform dermatitis in 1 each (0.5%) respectively. The most common drug was analgesics (31.2%), followed by anti-microbials (26.25%), corticosteroids (8.75%), antiepileptics (7.5%), anti-leprosy drugs (7.5%), anti-retroviral drugs (6.87%), antitubercular drugs (3.75%) and other drugs (8.12%).</p><p class="abstract"><strong>Conclusions:</strong> Many dermatological conditions can be induced, imitated or aggravated by drugs hence it is necessary for the health care system to promote periodic reporting to regional pharmacovigilance centres to ensure drug safety for clinician’s awareness.</p>


2020 ◽  
Vol 13 (2) ◽  
pp. 69-72
Author(s):  
Manchala Pratap Reddy ◽  
◽  
Pogula Nagarjuna Reddy ◽  
G.Vijaya Kumar ◽  
◽  
...  

2020 ◽  
Vol 27 (06) ◽  
pp. 1119-1123
Author(s):  
Asif Ali Khuhro ◽  
Fazal Ur Rehman ◽  
Waqas Ali ◽  
Najmi Usman ◽  
Sanam Bano Rajper

Objectives: Childhood and adolescent obesity is increasing especially in developing countries like Pakistan. It seem to affect most socio-economic classes as well as all ethnicities and geographies. We planned this study to analyze the clinical and biochemical profile of obese as well as overweight children at a tertiary care hospital for the existence of metabolic syndrome. Study Design: Cross sectional study. Setting: Department of Pediatrics Medicine, Children Hospital Chandka Medical College / Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. Period: 1st July 2018 to 31st December 2018. Material & Methods: Children, aged 5 to 16 years, both gender, having BMI > 85th percentile regarding age and gender were enrolled. Demographic characteristics along with history, lifestyle parameters and physical examination were noted for all the study participants. Metabolic syndrome (Met S) was evaluated while overall results were presented in terms of proportions, mean and standard deviations. Results: A total of 78 cases were enrolled during the study period. There were 46 (58.9%) male and 32 (41.1%) female, with a male to female ratio of 1.4:1. Mean age amongst study participants was 10.8 years. We had 56 (71.8%) children as overweight whereas 22 (28.2%) obese. Acanthosis nigricans was the most common entity seen in 55 (70.1%) children during clinical examination. Metabolic syndrome was found to be present in 31 (39.7%) participants. Conclusion: Met S is not only limited to obese children as it can also affect children who are overweight.


2017 ◽  
Vol 381 ◽  
pp. 303 ◽  
Author(s):  
A. Ghosh ◽  
A.P. Thangavelu ◽  
T. Sugumar ◽  
P. Hazeena ◽  
S. Venkatasubramanian

2021 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Sumiya Bent Kalam ◽  
Sadia Islam ◽  
Mohammad Abdullah Az Zubayer Khan ◽  
Tanjina Akhter

Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59


2021 ◽  
Vol 28 (04) ◽  
pp. 527-532
Author(s):  
Kashif Rasheed Shaikh ◽  
Shumaila Shaikh ◽  
Sadia Tabassum ◽  
Shagufta Memon ◽  
Umair Ali Soomro ◽  
...  

Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante – cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA – assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians.


Author(s):  
Dr. P.G. Mohandas ◽  
◽  
Dr. Anukesh Vasu Keloth ◽  
Dr. Divya G Krishnan ◽  
Dr. Neema Rahman ◽  
...  

Introduction: Diabetes affects 88 million people in south-east Asia with a regional prevalence of8.8%, and of them, 77 million live in India. Diabetic Foot Disease is an important complication thataccounts for significant morbidity and mortality in a diabetic individual. Aim: This study wasconducted to study the presentation stage of diabetic foot disease during the pandemic period asseen at a tertiary care hospital in North Kerala. Methods: This was a retrospective cohort studycarried out on patients diagnosed with diabetic foot and admitted to the Department of Surgery of atertiary care hospital in North Kerala during the study period of 6months from July 2020 toDecember 2020. A sample size of 63 was calculated. Data were collected from the case records ofthe patients, and the stages of presentation, relevant blood investigations, culture reports,radiological imaging and arterial doppler ultrasound findings were noted. Results: In this study, atotal of 63 patients were included. Of the 63 patients, 51(80.9%) were males, and 12 (19.0%) werefemales with a male to female ratio of 4.25:1. The mean age of the patients was 57.74 years. In thisstudy, as per the Wagner-Meggitt Classification of diabetic foot, the most common stage ofpresentation of diabetic foot encountered was Grade III (42.9%) followed by Grade IV (28.6%),Grade II (19.0%) and Grade V (9.5%).Conclusion: This is in part may be due to financialconstraints of the patient's families due to lack of job, transportation difficulties, shortage ofmedicines, shutting down of small scale health care facilities and pharmacies, prolonged neglect ofwounds, discontinuing of regular medications and poor home wound care which in turn are due tothe frequent regional lockdowns as a result of the covid pandemic.


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