scholarly journals Profile of Children Presenting with Epilepsy in a Tertiary Health Care Centre in Bangladesh

2010 ◽  
Vol 23 (1) ◽  
pp. 46-50
Author(s):  
Md Belal Uddin ◽  
Md Mizanur Rahman ◽  
MA Mannan ◽  
MA Hossain ◽  
MS Hoq

Epilepsy is a common neurological problem in children. A retrospective study was carried out among the epileptic children attending in the child development and Neurology service center of the department of Pediatrics of Bangabandhu Sheikh Mujib Medical University, Dhaka over a period from September 1999 to September 2001. The aim of this study was to find out clinical profile of epilepsy in children attending in a tertiary care hospital. One hundred twenty children of 1 month to 15 years of age of both sexes were included. Febrile seizures and seizure due to acute CNS infection were excluded from the study. This study showed that epileptic children were mostly from urban area (58%) with M&F 3.14:1 and 50% of them between 1-5 years of age with mean age 2.67 years it was found that most of the children were term (86.55%); home delivered (67.80%), normal birth weight (86.55%), history of delayed crying (43.78%) and history of resuscitation (24.00%). Majority of the patients had perinatal history of irregular and no antenatal check up 51.25%. Common age of onset of seizures was found in the most cases (57.75%) before 1 year of age. GTCS (48.27%) was the commonest pattern of seizure. Epileptic children were mostly severe type (71.70%), which were associated with daily seizure discharged (66.67%). Some of the patients (39.53%) were associated with known provoking factors. Gross motors (58.62%) were the common associated impairment or disability of the epileptic patients. About one third of the patients (32.46%) were associated with cerebral palsy where quadriplegic type was common 48.65%). A significant number of patients (44.8%) were treated previously with AEDs. Among them 60% were treated with single drug. Fifty one percent of the epileptic children were treated inadequately. After attending in the neurology center 69.25% of the patients were getting mono therapy and polytherapy was given in 30.48% of the patients. Carbamazipine and Valproate were commonly used in initial treatment. After initial treatment, control of seizures occurred in 54.25% of cases at different duration. With poly therapy 22.22% of patients did not response with AEDs. During the study period total 26 patients were remain seizures free at different duration. TAJ 2010; 23(1): 46-50

2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.


2016 ◽  
Vol 23 (01) ◽  
pp. 015-019
Author(s):  
Afsheen Qazi ◽  
Amin Fahim ◽  
Aneela Qureshi3 ◽  
Mazhar ul Haque

Objectives: The present study was designed to find the importance of properscreening and early diagnosis of gestational diabetes mellitus. Study Design: A prospective/descriptive study Place of Study: tertiary care hospital Hyderabad. Duration of Study: fromSeptember 2014 to November 2014. Materials and Methods: A total of 168 pregnant femalesbetween the ages of 20-40 years & in their 24th to 28th week of gestation were enrolled for thestudy. Oral Glucose Tolerance Test of all the participants was done after an overnight fasting of10-12 hours. All the participants were given 75gm of glucose per 100 ml of distilled water. Theblood samples were collected after two hours time for serum glucose levels. Results: Mostof the participants were below 26 years of age 47(27.9%) with the mean age of 30.2±5.83years. However the highest prevalence of GDM was observed in age group 31-35 years (36%).Among the 25 cases of gestational diabetes mellitus the highest number of patients with GDMwere multipara (40%) followed by parity of 3-4 gravida (32%). Twenty seven women (16%)women had family history of diabetes mellitus. Among these 12/27 (44.4%) women were foundwith GDM, compared to 15/141 (10.6%) who have no family history of diabetes mellitus. Total14 (8.33%) women were found obese, out of these 8 (57%) women had GDM while only 6(42.8%) women had no GDM. Conclusion: The prevalence of GDM in the present study isfound to be 14.8%. A prevalence of GDM was higher in the elderly multiparous females whowere overweight and had family history of diabetes mellitus.


Author(s):  
Dr. Shahid Hassan

INTRODUCTION: The current perception among dermatologists based on their experience in the outpatient’s clinics is that there is a huge change in clinical profile, both qualitative and quantitative, in the patients presenting with dermatophytosis. The prevalence of superficial mycotic infection is about 20%–25% of the world population, and dermatophytes is the leading microorganism responsible. Now there is a changing trend in the dermatophytic infections, the cases are presenting as chronic, not responding to usual treatment and also there are recurrent cases. Dermatophytosis is a contagious disease that spreads by direct or indirect contact. Until a few years ago, it had been a disease treated with ease using antifungal agents. In the recent past, there has been a failure of treatment with conventional therapy and emergence of an epidemic of recurrent and chronic dermatophytosis in India. MATERIAL AND METHODS: Our study population included 112 patients who were clinically diagnosed as dematophytosis in the Outpatient department (OPD). Clinical history of all patients was taken. Demographic data such as age, sex, occupation, duration of disease, history of recurrence, habits and associated diseases was recorded. Culture were done in all suspected cases. Nail scrapings, clippings and sub-ungual debris were collected. RESULTS: In present study there were in all 112 patients among which maximum number of patients about 33% belonged to age group 11 to 20, majority of which were males 66.96% whereas 33.04% were females. 50% were culture positive among all patients and microscopy was positive in 58.93% of cases. Trichophytonrubrum species was isolated predominantly in 57.1% cases, Trichophytonmentagrophyte was found in 23.2% of patients followed by microscoporumgypsium isolated in 12.5% cases and E.floccosum was seen isolated in 7.1% among all clinical types. Percentage of tineacorporis, tineacapitis and tineacruris was 39.3%, 18.8% and 13.4% respectively. CONCLUSION: Dermatophytosis was found to be common in second decade of life and male were commonly affected. T. rubrum was most common isolate. The need of the hour is carry out multicentric large epidemiologic studies that can effectively establish the prevalence of fungal isolates and its antifungal resistance status.


2009 ◽  
Vol 22 (2) ◽  
pp. 235-238
Author(s):  
MA Haque ◽  
MA Alim ◽  
I Mahmood ◽  
MM Hoque Chowdhury

Drug induced esophagitis, also known as pill-induced esophagitis or drug-induced esophageal injury, is uncommonly encountered in clinical practice. This observational study was jointly carried out by the Department of Medicine and Department of Gastroenterology, Rajshahi Medical College, from January 2005 to December 2009. Total number of patients included was 32. Patients who presented with history of odynophagia and chest pain after ingesting some medications and having endoscopic evidence of esophagitis were included in this study. Out of 32 patients 17 were female and 15 were male (F: M=1.1:1). Mean age of the patients were 36.7±8.5 years. Doxycycline was the drug most commonly associated with esophagitis, 25 cases (78.1%) had doxycycline induced esophagitis. Other drugs were tetracycline in 3 cases (9.4%), alendronate in 1 case (3.1%), ciprofloxacin in 1 case (3.1%), paracetamol in 1 case (3.1%), and naproxen in 1 case (3.1%), Increased awareness among the physicians and patient education can prevent this distressing clinical condition.TAJ 2009; 22(1): 235-238


2019 ◽  
Vol 7 (2) ◽  
pp. 4-8
Author(s):  
Sandip Subedi ◽  
Alok Pandey ◽  
Shirish Aryal

INTRODUCTION:-Backache is a common problem with about 70% of people in developed countries experience low back pain at some time in their lives. A number of studies done previously shows that there is high prevalence of depression in patients with chronic backache. This study was carried out to find out the prevalence of depression in patients with chronic backache in Nepalese subjects. MATERIAL AND METHODS:-This was a cross-sectional descriptive study conducted in Universal College of Medical Sciences, Bhairahawa, Nepal. Patients presenting to Orthopaedics OPD with history of backache lasting for more than 12 weeks were referred for psychiatric evaluation. One Hundred cases were included in the study based on inclusion / exclusion criteria in six months period (from 1st  Jan 2019 to 30th  June 2019). Detailed evaluation was done by a psychiatrist to find out the presence of depression. Diagnosis of depression was made based on ICD-10 DCR. Data was analysed using SPSS. RESULTS: Out of total 100 subjects, more than half (56%) were females. Majority of the subjects (61% ) were below 45 years of age. The average age of the subjects was 45 years minimum age being 16 and maximum 77. About 59% were also suffering from depressive disorder. CONCLUSION: This study concludes that significant number of patients with chronic backache attending OPD of tertiary care hospital suffers from depression. It is therefore essential to screen for depression in these patients.


Author(s):  
Arti Muley ◽  
Mitali Rathod ◽  
Kunjan Shah ◽  
Nikhil Patel ◽  
Aakash Patel ◽  
...  

Background: Chronic kidney disease (CKD) has become a major cause of morbidity and. in some parts of the world CKD incidence has increased regardless of hypertension, diabetes mellitus or metabolic syndrome. This study was done to identify the unknown factors which can be contributing to the increased incidence of CKD.Methods: It was a case control study. There were 61 cases and 50 controls. A detailed history regarding residence, occupation, addiction, drug intake, family history, diet and environmental factors was taken. The data was analysed to identify a common factor amongst the CKD patients who did not have history of any known risk factors of CKD.Results: Age of onset of CKD in 48% of cases was <40 years. Much higher percentage of cases gave family history of CKD (10%), history of consumption of NSAIDs (20%) and smoking for >5 years (30%) as compared to controls. Much more cases as compared to controls gave history of mixed diet (46% vs 26%). Much higher proportion of cases had history of heat exposure, excessive heating and sugarcane exposure (72%, 70% and 48% respectively) as compared to controls.Conclusions: This study supports the association of sugarcane exposure, heat exposure and excessive sweating with CKD and reports a changing trend of renal involvement starting at an earlier age. It highlights need of study with sufficient sample size and greater emphasis on family history, smoking, extent of heat exposure and sugarcane exposure to help identifying area of further research and guide policy making.


2021 ◽  
Vol 15 (11) ◽  
pp. 3076-3077
Author(s):  
Fauzia Siraj ◽  
Rabbiah Manzoor Malik ◽  
Zafar Iqbal ◽  
Rifat Shamim ◽  
Attya Zaheer ◽  
...  

Aim: To study the frequency and factors associated with peritoneal involvement among patients operated for acute appendicitis in a tertiary care hospital. Place and duration of study: Department of Surgery, Benazir Bhutto Hospital Rawalpindi Pakistan from 1stJuly 2020 to 30thJune 2021. Methodology: This comparative cross-sectional study 500 patients diagnosed as acute appendicitis and operated by consultant surgeon were included. Peritoneal involvement was defined as signs of inflammation or infection on abdominal lining observed by operating surgeon during the time of surgery. Factors like age, gender, presence of comorbid illnesses and history of previous abdominal surgeries were associated with presence of peritoneal involvement. Results: There were 305 (61%) males while 195 (39%) were females with mean age was 32.331±4.544 years.Four hundred and forty two (88.4%) did not show any peritoneal involvement at the time of surgery while 58 (11.6%) had peritoneal involvement. Chi-square test revealed that history of previous abdominal surgeries and advancing age had statistically significant association with peritoneal involvement among the study participants (p-value<0.05). Conclusion: Peritoneal involvement was found in considerable number of patients operated as acute appendicitis by the treating surgeons. Patients with previous history of abdominal surgeries and advancing age were more at risk of having peritoneal involvement in our study. Keywords: Acuteappendicitis, Peritonitis, Risk factors, Frequency


2021 ◽  
pp. 39-41
Author(s):  
Nikki Kumari ◽  
Rajesh Kumar ◽  
Gopal Saran ◽  
A. K. Jaiswal

Introduction: Convulsions are one of the most common paediatric neurological disorder worldwide. It could either be idiopathic or secondary to disease process of brain. Incidence of convulsion is highest among children younger than 3 yrs. Aims And Objectives: Current study was done to know the proportion of idiopathic epilepsy and secondary seizures. It further aimed to identify various aetiologies of convulsion in children between 1month to15years of age. Materials And Methods: It was a descriptive study conducted in patients admitted in emergency and indoor of department of paediatrics, Patna Medical College and Hospital, over a period of 2 years from October 2014 to September 2016. Children from 1 month to 15 years of age with seizures were studied to know the various aetiologies and proportion of idiopathic or secondary seizures. Results: During study period, 200 children between ages 1 month to 15 years, with convulsion, were enrolled. Seizures were found to be more common in males (67.5%). Secondary seizures were present in 90% cases and idiopathic epilepsy accounted only for 10%. GTCS was the commonest type of seizure both in idiopathic epilepsy (100%) as well as in secondary seizure group (87.77%). Family history of seizure disorders was present in 13% of cases. Developmental delay was found in 11.5% cases, whereas 88.5% children were developmentally normal. Infective aetiologies were the commonest cause followed by febrile seizures. Febrile seizures were commonly seen in age group between 1yr - 5yrs (23.75%). Hypocalcemic seizures were mostly seen in the age group of 1month to 1 year (17.5%). Japanese encephalitis virus and dengue virus as a cause of viral meningoencephalitis were found in 10% and 5% respectively. Conclusion: Incidence of idiopathic epilepsy was less common than secondary seizures. GTCS was the commonest seizure type. CNS infection and febrile seizures were common causes of convulsion in this age group. Bacterial infections were the commonest CNS infections. Serum electrolytes, lumbar puncture, neuroimaging, EEG were important tools in reaching diagnosis


2021 ◽  
Vol 12 (1) ◽  
pp. 41-44
Author(s):  
Nahid Sultana ◽  
Shahana Shermin ◽  
Jesmin Jerin ◽  
Samsad Jahan

Background: In developing countries like Bangladesh major population lives in rural areas, lacking access to essential obstetric facilities. Timely referral can reduce maternal morbidity and avoid maternal death in many instances. However lack of structured referral system is a major hurdle that delays proper management of such cases. The objective of the study was to review the pattern of obstetric cases admitted in our hospital, to study the clinical course and management of women during the hospital stay and to study the maternal and perinatal outcomes in terms of live birth or still birth, intra uterine fetal death and neonatal admission. Methods: It is a retrospective observational study conducted in the department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, from July 2018 to June 2019, including2880 obstetric cases admitted in the hospital. Detailed history of the patients were taken, frequency of each disease was calculated separately. Management of the patient and mode of delivery were noted. Fetal outcome parameters like live or still birth and intra uterine fetal death were noted. Results: Among 3953 admitted patients, obstetric cases were 2880 (73%).Maximum number of patients were booked cases(84.09%) and 75% were from urban area. The patients were in the age group from 18 to 40 years,32% were primigravida and 68% were multi gravida. Majority of our admitted patients had either diabetes mellitus or gestational diabetes mellitus, 58.19% and 23.95% respectively. Common co morbidities and obstetric complications were hypertensive disorder of pregnancy, anaemia, premature rupture of membrane, oligohydramnios and fetal growth restriction. Among the 2084 delivered cases were delivered by ceasarean section (86.42%) 13.53% were delivered vaginally. Commonest indication for cesarean delivery was history of previous cesarean section. Conclusion: Wide spectrum of complicated obstetric cases were admitted to our tertiary care hospital. Many complicated patients were referred from different centers for special management. But delayed referral sometimes could not help properly and also resulted in a high number of cesarean section. BIRDEM Med J 2022; 12(1): 41-44


2003 ◽  
Vol 24 (6) ◽  
pp. 415-421 ◽  
Author(s):  
Joel T. Fishbain ◽  
Joseph C. Lee ◽  
Honghung D. Nguyen ◽  
Jeffery A. Mikita ◽  
Cecilia P. Mikita ◽  
...  

AbstractObjective:To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.Design:A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA Risk factors associated with the likelihood of MRSA colonization on admission were investigated.Setting:Tertiary-care military medical facility.Participants:All patients admitted to the medicine, surgery, and pediatric wards, and to the medical, surgical, and pediatric intensive care units were eligible for inclusion.Results:Five hundred thirty-five admission and 374 discharge samples were collected during the study period. One hundred forty-one patients were colonized with methicillin-susceptible S. aureus (MSSA) and 20 patients (3.7%) were colonized with MRSA on admission. Of the 354 susceptible patients, 6 acquired MRSA during the study for a transmission rate of 1.7%. Patients colonized with MRSA on admission were more likely to be older than non-colonized or MSSA-colonized patients, to have received antibiotics within the past year, to have been hospitalized within the prior 3 years, or to have a known history of MRSA. Patients acquiring MRSA had an average hospital stay of 17.7 days compared with 5.3 days for those who did not acquire MRSA. Pulsed-field gel electrophoresis of the 6 MRSA isolates from patients who acquired MRSA revealed 4 distinct band patterns.Conclusions:Most patients colonized with MRSA were identified on admission samples. Surveillance cultures of patients admitted may help to prevent MRSA transmission and infection.


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