scholarly journals How Often Excitation Precipitates Seizure? Relative Difference of Frequency and Significance in Different Types of Epilepsy

2012 ◽  
Vol 13 (2) ◽  
pp. 143-146 ◽  
Author(s):  
KM Rahman ◽  
RN Chowdhury ◽  
ATMH Hasan ◽  
KFM Ayaz ◽  
T Miah ◽  
...  

Background: Epilepsy is a chronic neurological disorder, which presents with recurrent, unprovoked seizures. Seizure occurs spontaneously usually, but there may be association of various triggers. These triggers may act as seizure precipitating factors (SPFs). Objective: To find out the frequency of excitation as a SPF and its relationship to different types of epileptic patients attending Neurology and Medicine outpatient department (OPD) of a tertiary care hospital in Bangladesh. Methods: This was a cross sectional study carried out in specialized epilepsy weekly outdoor clinic of Neurology and Medicine outpatient department (OPD) of Dhaka Medical College Hospital from January 2008 to July 2011. Epilepsy syndromes were broadly classified into four categories using the classification system of International League Against Epilepsy (ILAE) namely, generalized epilepsy (GE), localization related epilepsy (LRE), symptomatic and unclassified. Each patient was evaluated and classified by consultant neurologist. All participants were interviewed through a predesigned close ended questionnaire to identify frequency of excitation as a SPF. Result: Among all the patients 71.5% were male, with most common age group at the time of interview was 11-20 years (36.8%). About 62% could identify at least one precipitator. Excitation (25.2%) was the most common SPF reported by patients followed by emotional stress in 17.7%. Excitation was found to be significantly associated with generalized epilepsy (p<.000). Conclusion: Most of the patients can identify their seizure precipitant. Excitation showed a strong association with generalized epilepsy. DOI: http://dx.doi.org/10.3329/jom.v13i2.12748 J Medicine 2012; 13 : 143-146

2013 ◽  
Vol 3 (1) ◽  
pp. 29-31
Author(s):  
Swapna Bhattacharjee ◽  
Shekhar Bhattacharjee ◽  
Rukhsana Parvin

Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31


2018 ◽  
Vol 4 (2) ◽  
pp. 116-122
Author(s):  
Mohammad Niamat Alahi ◽  
Md Anowar Hossain ◽  
Abu Sayeed Mohammad

Background: Skin diseases account for a higher proportion of outpatient department in developing countries including Bangladesh.Objective: The purpose of the present study was to evaluate the pattern of skin diseases in patients attending OPD of Dermatology and venereology in a tertiary care hospital.Methodology: This cross-sectional study was conducted in the outpatient department of medical college hospital of Kishoreganj in Bangladesh from 2013 to 2016 for a period of four (4) years. All the patients at any age and sex who were attended in the OPD of the hospital selected as study population. Only newly diagnosed cases were included in the study. The socio-demographic profiles and diseases pattern were recorded in a data sheet. Diagnosis was made on clinical basis by expert dermatologist. Lab investigations were restricted to the cases where it carried diagnostic importance.Result: A total number of 119228 patients (near about 82/day) were recruited for this study. Out of them 57825 (48.5%) cases were male and 61403 (51.5%) cases were female. Infective diseases were more common than non-infective diseases which were (65409; 54.9%) and (53819; 45.1%) cases respectively. In cases of infective diseases; parasitic, fungal, bacterial, viral, sexually transmitted infection and other nonspecific infections were 20408(31.2%), 17464(26.7%), 12166(18.6%), 8503(13.0%), 3597(5.5%) and 3271(5.0%) respectively. Out of 20408 parasitic diseases of which 20061(98.3%) cases were scabies and 1347(1.7%) cases were pediculosis. Out of 17464 fungal diseases tinea capitis, tinea corporis, tinea cruris, candidiasis, onychomycosis and pityriasis versicolor were found in 2655(15.2%) cases, 3737(21.4%) cases, 3423(19.6%) cases, 3127(17.9%) cases, 1031(5.9%) cases and 3492(20.0%) cases respectively. Out of 12166 bacterial diseases Impetigo was found in 4745(39.0%) cases, pyoderma in 4282(35.2%) cases, folliculitis in 3103(25.5%) cases, leprosy in 24(0.2%) cases and skin TB in 12(0.1%) cases. Among the viral diseases verruca was found in 4056(47.7%) cases. In case of non-infective diseases, eczema, papulo-squamous disease, acne, urticarial, drug reaction, vitiligo, chronic arsenicosis, neoplastic skin disorder, genodermatoses and others were 16953(31.5%), 9903( 18.4%),7696( 14.3%), 8019( 14.9%), 4682( 8.7%), 2099( 3.9%), 269(0.5%), 161(0.3%), 431(0.8%) and 3606( 6.7%) respectively.Conclusion: In conclusion, we found that a huge burden of skin diseases are present in the OPD. Infective skin diseases mostly bacterial and parasitic still predominant in Bangladesh though it is less frequent in developed countries.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 116-122


2020 ◽  
Vol 27 (06) ◽  
pp. 1285-1290
Author(s):  
Ahmed Ali Kanhar ◽  
Waseem Raja Memon ◽  
Nasrullah Aamer ◽  
Bahkat Ali Sial ◽  
Abdul Aziz Sahito ◽  
...  

Objective: To determine the frequency of acute renal failure in patients presented with Blackstone poisoning in a tertiary care Hospital. Study Design: Cross sectional study. Setting: Medical wards and ICU at Peoples Medical College Hospital, Nawabshah. Period: September 2017 to March 2018. Material & Methods: All the patients of age 20 to 50 years having Paraphenylenediamine (PPD) poisoning (kala-patthar) during ≥6 hours after ingestion and either of gender were included. AKI was labelled as positive if either of any stage was present on the basses of urine output measurement for 24 hours through urine beg r urine output (UO) criteria. All the data was documented in self-made proforma. Results: The mean age for patients was 24.9±8.9 years, 46(19.08%) subjects were male and 195(80.91%) were female. 18(7.5%) study subjects had acute renal failure, out of them 6 study subjects had ARF of stage I, 5 patients had stage II and 7 study subjects had acute renal failure stage III. Conclusion: Acute renal injury is a common complication following PPD ingestion 7.5%. Paraphenylenediamine toxicity is a threat to the region of Asia and is evolving as a substitute to the poisoning of organophosphorus due to its easy accessibility and low cost.


2020 ◽  
Vol 7 (1) ◽  
pp. 12-17
Author(s):  
Anika Tasnim ◽  
AKM Shamsuzzaman ◽  
Md Shah Alam ◽  
Jannatul Ferdose ◽  
Fazlay Akbar Khan

Background: Patients of burn wound are generally more susceptible to infection due to concurrent status of malnutrition and immunosuppression. Among many bacteria, MRSA has appeared as a challenging pathogen irrespective of effective antibiotic therapy. Objective: The purpose of the present study was to detect the prevalence and antibiogram of MRSA in burn wound infected patients. Methodology: The present cross sectional study was conducted at Department of Microbiology in Rajshahi Medical College, Rajshahi, Bangladesh. The samples were collected from Burn and Plastic Surgery Unit of Rajshahi Medical College Hospital, for a period of one year. Phenotypic detection of MRSA were done by cefoxitin disc diffusion method and genotype (mecA gene) was detected by PCR which was conducted at Dhaka Medical College, Dhaka among all the S. aureus isolates. Result: A total of 212 wound swabs were subjected to bacteriological culture media for isolation of MRSA and other organisms. As a whole 89.62% samples yielded growth in culture of which Pseudomonas aeruginosa was the predominant pathogen (34.18%). Out of 21 S.aureus isolates, 07(33.33%) were detected as MRSA by cefoxitin resistance and presence of mecA gene. Although over 85% MRSA were resistance to ciprofloxacin and ceftriaxone, but the present study could not detect any vancomycin resistant MRSA. Conclusion: The high prevalence and decreased sensitivity of MRSA to commonly used antibiotics has been observed in Burn Unit of RMCH. Therefore it is necessary to establish an antimicrobial surveillance system in hospital settings to prevent the spread of MRSA. Bangladesh Journal of Infectious Diseases 2020;7(1):12-17


2017 ◽  
Vol 29 (1) ◽  
pp. 10-13
Author(s):  
Mohammad Tariqul Alam ◽  
Mohammad Muntasir Maruf ◽  
Mekhala Sarkar ◽  
Helal Uddin Ahmed ◽  
Mahfuza Akhter

Pattern of prescriptions for psychiatric patients varies which is influenced by patient variation, types of disorders, cultural and environmental influences, socioeconomic status, availability of drugs and psychiatrists own preference. The aim of this study was to determine the patterns of prescribing psychotropic drugs in psychiatry Outpatient Department (OPD) in a tertiary care hospital. The cross-sectional study was conducted in the OPD of National Institute of Mental Health (NIMH), Dhaka from January to June, 2016. In the study, the prescriptions prescribed by psychiatrists were considered as study population. Using convenient sampling method, data were collected by observation using checklist from selected 604 latest prescriptions prescribed by psychiatrists in OPD of NIMH for the patients coming there for treatment. The data on the psychotropic drugs collected for the study were antipsychotics, antidepressants, mood stabilizers and sedative-hypnotics. Results showed that a total of 1802 psychotropic drugs were prescribed with an average of 2.98 psychotropics per prescription. The most common drug group prescribed was antipsychotics (44.8%). Majority (49.7%) of the prescriptions contained 3 psychotropics simultaneously. Most common (27.8%) combination was that of antipsychotics and sedativehypnotics. Dosage regimen was twice/day for the majority (55.6%). There was a combination of oral and parenteral drugs in 48.3% of prescriptions. All the drugs were prescribed by brand names. There was no diagnosis written in 60.9% of the prescriptions. The prescription pattern was not rational and this should be intervened by educating prescribers about rational prescribing in psychiatry.Bang J Psychiatry June 2015; 29(1): 10-13


Author(s):  
S. Dhanya Dedeepya ◽  
Vidhyasagar Krishnamoorthy ◽  
P. Ambikapathy

Aim: To assess the knowledge, attitude and belief of Parents about fever in their children and how they respond to it while at home and when they seek medical attention. Objectives: The purpose of this study is to know the preexisting knowledge of parents about fever in their children and to impart additional knowledge to them. Materials and Methods: A Cross- Sectional study in the form of a questionnaire was conducted at a tertiary care hospital among parents of children visiting the outpatient department and those admitted as inpatient with fever. Children who presented to the emergency room and those with chronic illnesses were not included. Majority of the primary caregivers was the child's mother, and family becomes the 1st point of contact for the intervention, hence we chose family. As per our department that at least 80% of children were primarily brought to OP for fever, and 90% of those admitted in wards were for febrile illnesses, with or without other associated problems, we asked the statistician to come up with an adequate number and we were given.  Results: A total of 100 parents were selected and interviewed. The informants were mostly mothers (83%). Most of the children were brought to outpatient department within the first five days of onset of fever (68%). The parents said that they confirmed the fever by touch(86%)and most of them prefer to consult the pediatrician before giving any medication (56%).The most common symptoms which were seen associated with fever are cough, cold  and  running nose (54%).The most common cause for worry amongst parents are complications like febrile seizures (43%). Conclusion: Fever is one of the most common complaints with which patients come to the hospital. Majority of parents in this study do not have the practice of documenting fever at home with a thermometer. Inadequate parental knowledge about the nature of fever can lead to poor management. Appropriate education helps them to take appropriate measures when their child develops fever.


2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Nimesh Poudel ◽  
Subodh Sagar Dhakal ◽  
Renu Sukhupayo ◽  
Dambar Bahadur Karki

Introduction: Vitamin D deficiency is a common condition prevalent among both developed and developing countries where it is seen mostly in females. It has been linked to various skeletal and non-skeletal diseases. This study was done to find out the prevalence of Vitamin D deficiency and clinical features of deficient patients attending the outpatient department of a tertiary care hospital. Methods: This descriptive cross-sectional study was done among the patients attending the outpatient department of a tertiary care hospital in Kathmandu, Nepal. The study was conducted from May 2019 to July 2019. The ethical approval was taken from the Institutional Review Committee (ref no. 310520113). Convenient sampling was done. The collected data was entered in Microsoft Excel and was analyzed in the Statistical Package for the Social Sciences (SPSS) version 26. Results: Out of 481 participants, the prevalence of vitamin D deficiency was 335 (69.6%). Severe vitamin D deficiency was seen in 78 (16.2%) and insufficient vitamin D in 77 (16%) of the patients. The mean serum vitamin D concentration by gender was 22.38±17.07 ng/ml in males and 18.89±15.25 ng/ml in females. A total of 263 (54.6%) females and 72 (14.97%) males had vitamin D deficiency. The most common symptoms found in vitamin D deficiency patients were fatigue 187(55.8%), muscle cramps 131(39.1%), generalized myalgia 125(37.31%), bone and joint pain 111(33.13%) Conclusions: Vitamin D deficiency was prevalent especially in females and elderly people. Fatigability was present in more than half of the vitamin D deficient patients.


2021 ◽  
Vol 10 (1) ◽  
pp. 29-32
Author(s):  
Sanjib Bandyopadhyay ◽  
Kaushik Mitra ◽  
Dipankar Bhaumik ◽  
Saibal Das

Objective: This study was conducted to evaluate the potential drug-drug interactions (pDDIs) among patients admitted in a tertiary care hospital in India. Methods: This was anobservational and cross sectional study for 3 months. All the patients admitted in the general ward under Department of Medicine. Pre-structured proforma and patient’s charts were be used for data collection on the 2nd day of admission. For drug interactions, online ‘Medscape Drug Interaction Checker’ was used. Results: A total of 61 charts were screened. A total of 304 drugs with 57 different types were admitted to these patients (including all dosage forms and routes). The total number of pDDIs were 217, of them 69 were minor, 130 were significant and 18 were serious (including repetitions in different patients). There were 13 unique serious pDDIs. Conclusion: The incidence of pDDIs in our study was high. Controlled study to evaluate whether good clinical management of DDIs can reduce drug-related morbidity or mortality is needed. Keywords:Potential drug-drug interactions (pDDIs), adverse drug reactions (ADRs), poly-medication, hospitalization, pharmacokinetic and pharmacodynamics interactions.


Author(s):  
Ashis Samuel John ◽  
Kamaxi M. Bhate

Background: Inadequate understanding by patients of medical prescription given to them adversely affects treatment compliance; which can result in treatment failure and increase the incidence of adverse effects. The study site is a tertiary care hospital in a metropolitan city and the patients attending here are particularly vulnerable in this regard both due to the heavy patient load in the outpatient department and their low socioeconomic status.Methods: This was a cross sectional study conducted in the pharmacy of K.E.M. Hospital, Mumbai over a period of 1 month. Study population included general outpatient department patients of the hospital. Patients were interviewed using a pre validated questionnaire and their knowledge of the prescription analysed under five key aspects including dose, timing, duration, side effects and purpose of each drug. Data was entered using Microsoft Excel and analyzed using SPSS 22 software.Results: The mean age of the population was 37.6, with a standard deviation of 12.4. A good overall knowledge of the prescription was present only in 12.4% patients. In 52% of patients, the level of knowledge ranged from ‘no knowledge to little knowledge’. Age and literacy had statistically significant associations with overall knowledge of prescription.Conclusions: There is a significant gap in prescription knowledge in the study population. Age and literacy of the patient has an effect on prescription knowledge.


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