RELATIONSHIP OF HYPONATREMIAAMONG PATIENTS ADMITTED IN ICU OF A TERTIARY CARE HOSPITAL IN WEST BENGAL

2021 ◽  
pp. 1-3
Author(s):  
Partha Pratim Dey ◽  
Debarshi Jana

Introduction: Hyponatremia is a serious adverse event in the paediatric critical care population is especially complex as many patients require multiple continuous infusion and excess uid volumes due to hypovolemic shock or blood pressure instability. Aim & objective:To detect hyponatremia among patients admitted in medical icu of agmc & gbph and to study its etiology. Objectives 1. To nd out the proportion of patients admitted in icu having hyponatremia. 2. To study the etiology of hyponatremia in these patients. Material & methods: One year starting from 1st Nov 2019 to 31st October 2020. All the patient admitted in the ICU; age more than 18 years, size was depend on the total admission within the study period in General Medicine, Murshidabad Medical college and R. G. Kar Medical college, West Bengal. Conclusion: We found that most common age group 41-60. It was found that male were predominance than female. It was found that 96(27.9%) patients had Hyponatremia We found that 22(6.4%) patients had Euvolemia, 49(14.2%) patients had Hypervolemia, 25(7.3%) patients had Hypovolemia and 248(72.1%) patients had normal.

2021 ◽  
pp. 12-15
Author(s):  
Smarajit Banik ◽  
Sandip Saha ◽  
Sudipan Mitra ◽  
Ujjwal Pattanayak ◽  
Rajib Sikder ◽  
...  

Background: Diabetes mellitus is one of the important causes of morbidity and mortality. With a rise in non communicable diseases in India, diabetes has become a modern epidemic showing a rising trend in West Bengal also. A large number of diabetes patients come to the diabetes clinic of our tertiary care hospital in North Bengal Medical College and Hospital, Darjeeling, West Bengal. The large proportion of patients presenting with this condition prompted us to study the Sociodemographic and Anthropometric Prole of such patients. Methods: This was a descriptive hospital based cross sectional study involving a total of 344 diabetic patients enrolled in the diabetes clinic of a tertiary care teaching hospital from December 2019 to February 2020. A self-administered questionnaire was used to collect data and was analyzed in Microsoft excel sheet and using SPSS 20.0 software. Results: Among the 344 study participants, we found that 220 (63.95%) were males and 124 (36.05%) were females. Diabetes was more common among those aged 51-60 years 108 (31.40%). Family history was present among 188 (54.65%) of the diabetic patients. Almost 160 (46.51%) patients have diabetes 1.1 – 5 years. Hypertension was present among 216 (62.79%) patients. Almost 218 (63.37%) of the patients were overweight and 84 (24.42%) were obese. Conclusions: The diabetic patients presenting to this tertiary care hospital belong lower socioeconomic strata and having limited education in their age group. There is high proportion of obesity and hypertension among them.


2020 ◽  
pp. postgradmedj-2019-136992
Author(s):  
Kuo-Kai Chin ◽  
Amrita Krishnamurthy ◽  
Talhah Zubair ◽  
Tara Ramaswamy ◽  
Jason Hom ◽  
...  

BackgroundRepetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive.ObjectiveTo evaluate the effect of a minimally restrictive EHR-based intervention on utilisation.SettingOne year before and after intervention at a 600-bed tertiary care hospital. 18 000 patients admitted to General Medicine, General Surgery and the Intensive Care Unit (ICU).InterventionProviders were required to specify the number of times each test should occur instead of being able to order them indefinitely.MeasurementsFor eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured.ResultsUtilisation decreased for some tests on all services. Notably, complete blood count with differential decreased 9% (p<0.001) on General Medicine and 21% (p<0.001) in the ICU.ConclusionsRequiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.


Author(s):  
Aruna Rani R. ◽  
Dheeba Jayanthi R. ◽  
Eswari S.

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.


2021 ◽  
pp. 28-30
Author(s):  
Partha Pratim Dey ◽  
Debarshi Jana

Introduction: Hepatic encephalopathy is a frequent complication and one of the most debilitating manifestations of liver diseases, severely affecting the lives of patients. Aims and objective: i. To study the precipitating factors of hepatic encephalopathy. ii. To observe the clinical manifestation at the time of presentation of hepatic encephalopathy. iii. To observe the seasonal variation of hepatic encephalopathy in cirrhotic patient. Materials and method: General Medicine, Murshidabad Medical college and R. G. Kar Medical college in West Bengal. All adult cirrhotic Patients admitted with encephalopathy in the medicine ward within the study period. One year starting from 1st Nov 2019 to 31st October 2020. Conclusion: This study found that most common precipitating factors of hepatic encephalopathy in our patients are infection, constipation electrolyte imbalance and Variceal Haemorrhage bleeding. These are potentially preventable and reversible.


2020 ◽  
Vol 7 (43) ◽  
pp. 2492-2496
Author(s):  
Rajan Goyal ◽  
Himanshu Jindal ◽  
Abhilasha Singh ◽  
Abhishek Kamendu

BACKGROUND Diabetes is the most important risk factor for chronic kidney disease. Because of this, clearance of many oral hypoglycaemic drugs from our body is hampered and time of exposure to these drugs increases. Therefore, patients of diabetes need to be assessed frequently for the development of diabetic nephropathy and the dosage of oral hypoglycaemic drugs should also be modified accordingly. So, the purpose of this study was to evaluate the doses of prescribed OHAs in newly diagnosed diabetic nephropathy patients. METHODS A hospital based observational study was conducted at Narayan Medical College and Hospital, Sasaram, Bihar, India. A total of 600 diagnosed patients of diabetic nephropathy of age more than 18 years visiting for the 1 st time in OPD of general medicine / nephrology department were included in the study after obtaining an informed consent. The results were expressed as a percentage of the assessed population. RESULTS Only about 38% of the total study population was taking doses of Oral Hypoglycaemic Agents (OHAs) according to their GFR status. 62% were taking wrong doses of OHAs with their respective renal function. CONCLUSIONS Treatment of diabetes in a CKD patient is more difficult than in non-CKD patient. GFR status should be monitored on regular basis in patients of diabetes with CKD. A significant number of these patients are still treated with wrong dosage of OHAs for their respective renal function. KEYWORDS Wrong Dose of OHA, Diabetic Nephropathy, Oral Hypoglycaemic Drugs


Author(s):  
Siba Narayan Jali ◽  
Sachida Nanda Nayak ◽  
Biju K. Alexander ◽  
Diptimayee Tripathy ◽  
Bijaya K. Behera

Background: Apart from head injury many patients present to the tertiary care hospital in unconscious state, the etiology of which is obscure in most of the cases. The present study was conducted with on objective to provide insight into the clinical features and diagnostic methods to know the aetiology of patients with non-traumatic cases of altered sensorium and to study the outcome of these patients.Methods: This is an observational study on 100 patients of altered sensorium of non-traumatic origin during the period from October 2012 to September 2014 conducted in the Department of General Medicine, MKCG Medical College Hospital, Berhampur, Odisha, India. All patients were selected for the study based on the inclusion exclusion criteria. Detailed history, clinical evaluation, laboratory investigations like neuroimaging studies etc. were carried out. Statistical data analysis was done using Graph pad Prism 6 and Microsoft Excel. P value <0.0001 was considered statistically extremely significant.Results: Out of 100 patients of altered sensorium, 64 were males and 36 were females. All patients were in the age group of 19 to 89 years. Cerebrovascular accident was the most common aetiology of altered sensorium followed by metabolic encephalopathy and infection. Altered sensorium in patients with CVA carries a high mortality. Metabolic causes and younger age indicated a better prognosis, patients with low (Glasgow Coma Score) GCS score of 3 to 4 had poorer prognosis.Conclusions: The results suggest that clinical assessments yield accurate predictive information about the potential for recovery in cases of altered sensorium. So, this study concludes that empirically based estimates of prognosis in the neurologically severely ill provides great reassurance to those involved in a decision-making process, including patients’ families and physicians.


2019 ◽  
Vol 7 (1) ◽  
pp. 271
Author(s):  
Anand Gupta ◽  
Anshuman Sharma

Background: Specialized female surgical clinics are the basic requirement in surgical department which should be addressed routinely. The management of surgical problems in female patients requires multidisciplinary approach mainly general surgery, obstetrics and gynaecology, general medicine, paediatrics, dermatology and psychiatry. If proper care is provided then this will uplift the follow up of same patients in such clinics. The objective of the study was to assess the success rate of female surgical clinics and to determine the follow up visits done by female patients once visited the female surgical clinics.Methods: Prospective educational interventional study was conducted. A total of 952 patients visiting the clinic were studied. Statistical analysis was done.Results: Out of 952 cases 944 (99.2%) cases were willing to continue visit to the clinic, while 809 (84.9%) cases revisited for follow up treatment in female surgical clinics within one year duration.Conclusions: It can be concluded that there is a requirement and need of a fully functional specialized female surgical clinic in our hospital. As the success rate for follow up visit by patients in this clinic was high.


Author(s):  
Sitalakshmi V. ◽  
Alpana Bansal

Background: Transvaginal sonography (TVS) is very useful to assess the abnormalities in the anatomical structure of the uterus as well as endometrium. Not only this, it is capable of finding out any abnormalities of ovary, fallopian tubes, cervical structures as well as myometrium. The objective of the study was the role of transvaginal sonography in gynecological diagnosis at a tertiary care hospital.Methods: Present hospital based prospective study was carried out among 31 randomly selected eligible patients as per inclusion and exclusion criteria of the study for a period of one year at Department of Obstetrics and Gynecology of S. V. Medical College, Tirupati. All ethical guidelines were followed. A pre-designed and semi structured pre-tested questionnaire was prepared for entry of patient data.Results: Transvaginal sonography was more accurate in terms of evaluation of both tubes. Overall diagnostic accuracy of transvaginal sonography was 90.9%. It was found that the accuracy of clinical diagnosis was 100% in comparison to diagnosis by scan. In five cases, the clinical diagnosis of infertility was made as ovarian cyst and in all those cases it was confirmed. In three cases, the clinical diagnosis of infertility was made as fibroids and in all those cases it was confirmed. It was found that in cases of ectopic pregnancy, copper T missing loop and missed abortion, the clinical diagnosis was 100% accurate in comparison to scan diagnosis. Only in case of pelvic inflammatory disease, the accuracy of clinical diagnosis was 66% in comparison to scan diagnosis.Conclusions: Despite the few disadvantages of transvaginal sonography in measuring large pelvic masses, the smallest details of the masses yield valuable preoperative information. The more accurate delineation of internal echo characteristics scores the benefit over transvaginal sonography has its rightful place in gynecological practice has diagnostic and minimally invasive therapeutic tool.


Author(s):  
Philips Antony ◽  
Hafiz Deshmukh

Background: Since the introduction of the first flexible fiberoptic bronchoscope by Shigeto Ikeda in 1966, fiberoptic bronchoscopy (FOB) has been a valuable tool in the diagnosis of pulmonary diseases. Therefore, the aim of this study is to report our one-year experience with the yield of flexible fiberoptic bronchoscopy at MGM Medical College and Hospital, a tertiary hospital in Maharashtra.Methods: A retrospective study of fiberoptic bronchoscopy (FOB) was performed at MGM Medical College and Hospital, Aurangabad, Maharashtra during the period 2015-2016. Bronchoscopy was performed and collection of bronchial washing, bronchial brushing, bronchial biopsy and transbronchial needle aspiration was done.Results: Out of 192 patients, 140 were males and 52 were females. Majority of them were in age group 50-59 years. Main indication was pulmonary tuberculosis. Bronchial washings were done in 168 cases and brushing in 56 cases and common location for both was right upper lobe; bronchial biopsy was done in 90 cases with commonest location left main bronchus. Transbronchial needle aspiration was done in 4 cases, active bleed was seen in 6 cases and purulent discharge was seen in 24 cases. Bronchoscopic finding in majority of patients was normal tracheobronchial tree.Conclusions: The optimal use of conventional bronchoscopy and its techniques in the hands of experienced respiratory interventionists, with the adherence of the international guidelines for performing these techniques will improve the diagnostic outcomes of those patients with the least morbidity and mortality, employing better therapeutic strategies, and thus improving the overall management of those patients.


2021 ◽  
pp. 66-68
Author(s):  
Urvashi Singh ◽  
Gopal prasad singh ◽  
Alka Jha

Aim:To evaluate the efcacy of topical Voriconazole in the treatment of fungal corneal ulcer. Materials and methods: It was a single centre prospective tertiary care hospital based study conducted in the Upgraded Department of Ophthalmology at DARBHANGA MEDICAL COLLEGE AND HOSPITAL, Laheriasarai. It included 25 corneal ulcer patients of all demographic and socioeconomic status attending outdoor and/or indoor of Department of Ophthalmology, from April 2019 to April 2020, for a period of one year. Result: Majority of the patients were females.The decrease in ulcer size and improvement in visual acuity post treatment with topical Voriconazole was found to be statistically signicant. Conclusion: Topical therapy with 1% Voriconazole (w/v) served to be an economical mode of treating fungal corneal ulcer. It helped in the early and complete resolution of the ulcer with no adverse effects.


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