CLINICO-ETIOLOGICAL PROFILE OF HYPONATREMIA AMONG ADMITTED PATIENTS AT DR. RADHA KRISHNAN GOVT. MEDICAL COLLEGE AND HOSPITAL HAMIRPUR HIMACHAL PRADESH

2021 ◽  
pp. 25-28
Author(s):  
Subhash Chand ◽  
Rakesh Chauhan ◽  
Bavesh Barwal
Keyword(s):  
Early Recognition ◽  
Diagnostic Algorithm ◽  
The Elderly ◽  
Himachal Pradesh ◽  
Comorbid Conditions ◽  
Electrolyte Disturbance ◽  
Medical College ◽  
Number Of Patients ◽  
Laboratory Investigations ◽  
Material Study

Hyponatremia is a common electrolyte disturbance encountered in hospitals. It is dened as serum concentration <135 meq/l. Various comorbidities predispose to the development of hyponatremia. Patient has symptoms of both hyponatremia as well as comorbidities. This contributes to increased morbidity and mortality .However early recognition and treatment makes prognosis better. Aim: To study clinical features of patients admitted with hyponatremia and investigate them to nd out various aetiologies. Methods And Material: Study was conducted at newly opened medical college at Hamirpur in Himachal Pradesh with limited facilities. A total of 50 patients with symptoms and documented hyponatremia were enrolled in study. Detailed history, clinical examination and laboratory investigations were done. Data thus collected was analysed. Results: Total number of patients was 50. Females were more as compared to males. Mean age of presentation was 67 years and lethargy ,nausea and vomiting were the most common symptoms. Diabetes mellitus and hypertension were the most common comorbidities. Among drugs diuretics were the most commonly used causing hyponatremia. Out of 50 patients 45 patients recovered and ve patients have to be referred because of comorbidities. Conclusions: Hyponatremia is a common problem and clinicians need to be aware of it mainly in the elderly patients. A systemic approach and simple diagnostic algorithm can signicantly improve the outcome in these patients. Treatment of hyponatremia is governed by levels of hyponatremia not by its etiology along with comorbid conditions.

scholarly journals Disease Pattern at Medicine Outpatient Department of A Tertiary Care Hospital

2019 ◽  
Vol 18 (1) ◽  
pp. 27-30
Author(s):  
Raushan Akter ◽  
M Jalal Uddin ◽  
Rajat Sankar Roy Biswas
Keyword(s):  
Tertiary Care ◽  
Quality Of Healthcare ◽  
Outpatient Department ◽  
Common Disease ◽  
Care Hospital ◽  
Medical College ◽  
Number Of Patients ◽  
Disease Pattern ◽  
Laboratory Investigations

Background : Bangladesh, like many transitional nations, is straddling with the demographic and epidemiological transition. There is a critical need to improve public health in this region. But number of studies & representative data on the prevalence of diseases is inadequate. The objective of this study is to detect type & frequency of diseases among patients attending in medicine outpatient department (OPD) to improve the quality of healthcare. Materials and methods: This observational study was conducted at the outpatient department (OPD) of Chattogram Maa-O-Shishu Hospital Medical College from February to April 2018. Purposive sampling was used. Total 500 patients were included. Details were recorded in a data form and diagnosis was made on the basis of history, physical examination and necessary laboratory investigations. Data were collected and analyzed using the SPSS Version 20. Results : Total 500 patients were evaluated. Majority were female (61.2%). Highest number of patients i.e. 299 (59.4%) belonged to the age group of 16–35 years. Majority 405 (81%) of the patients in our study were from surrounding locality (Urban). The most common diseases was DM affecting 55(11%). HTN was 2nd common disease 51(10.2%). During this study we found gastrointestinal system was the most common affected organ system. Conclusion: Disease pattern study is very important to focus top problems, so that we can prepare ourselves to fight against them. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 27-30

Clinical Charecterstics and Out Come of Patients with Symptomatic Corona Virus Disease 2019 in Small District of Himachal Pradesh in India

2020 ◽  
Vol 9 (3) ◽  
pp. 12-15
Author(s):  
Subhash Chander ◽  
Anurag Thakur ◽  
Anil Verma ◽  
Nitin Tangri ◽  
Rakesh Chauhan
Keyword(s):  
Virus Disease ◽  
Stable Condition ◽  
Small Towns ◽  
Himachal Pradesh ◽  
Comorbid Condition ◽  
Common Symptom ◽  
Government Medical College ◽  
Geriatric Population ◽  
Medical College ◽  
Number Of Patients

Background: In India Covid 19 cases started rising after the Lockdown and from January 30 to August 02 there have been 18,07,222 confirmed cases of Covid 19 with 38176 deaths. Now Covid 19 cases are present in small towns and villages as people from major cities has been migrates to their native places. This study describes the demographic, baseline comorbidity, presenting clinical complaints and outcome of the first sequentially patients with COVID -19 in a small district from Himachal Pradesh, In India. Subjects and Methods: This retrospective observational study was conducted in Dr. Radha Krishnan Government medical college, Hamirpur, Himachal Pradesh, India. The inclusion criteria for the study was All symptomatic patients with laboratory-confirmed COVID-19 by Real time polymerase chain reaction (RT-PCR) in Distt. Hamirpur in Himachal Pradesh from March 2020 to 31 July 2020. Oral consent was obtained for the study. The medical records of patients were analysed by the research team of the department of medicine, Dr. Radha Krishnan Government Medical College Hamirpur. Results: Maximum number of patients (92%) migrated from outside the state and majority from the cities of high number of Covid cases. During hospital periods 36% patients had peripheral capillary spo2 less than 95% and required oxygen support. 2(4%) patients died in the hospital and 5(10%) was referred to higher centre. 43(86%) patents recovered and discharged in stable condition. Fever (64%) was the most common symptom followed by cough (60%), fatigue (40), rhinorrhoea (28%), headache (26%) and hypogeusia (16%). Conclusion : The clinical presentation was milder and complications were seen in very few. Special attention is required to the geriatric population and with severe comorbid condition, as they are more likely to have a poor outcome.

Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 6-15
Author(s):  
I. V. Kolykhalov
Keyword(s):  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Mixed Dementia ◽  
Short Term ◽  
Antipsychotic Therapy ◽  
Dementia Patients ◽  
Frequency Of Use ◽  
Number Of Patients ◽  
High Incidence

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

scholarly journals Letter to the Editor: Microbiota in the Respiratory System—A Possible Explanation to Age and Sex Variability in Susceptibility to SARS-CoV-2

2021 ◽  
Vol 14 ◽  
pp. 117863612098860
Author(s):  
Vishal Shah
Keyword(s):  
Respiratory System ◽  
Elderly Population ◽  
Age Groups ◽  
The Elderly ◽  
Elderly Adult ◽  
Human Respiratory Tract ◽  
System A ◽  
Number Of Patients ◽  
Children And Young Adults ◽  
Age And Sex

The Human respiratory tract is colonized by a variety of microbes and the microbiota change as we age. In this perspective, literature support is presented for the hypothesis that the respiratory system microbiota could explain the differential age and sex breakdown amongst COVID-19 patients. The number of patients in the older and elderly adult group is higher than the other age groups. The perspective presents the possibility that certain genera of bacteria present in the respiratory system microbiota in children and young adults could be directly or through eliciting an immune response from the host, prevent full-fledged infection of SARS-CoV-2. The possibility also exists that the microbiota in older adults and the elderly population have bacteria that make it easier for the virus to cause infection. I call upon the scientific community to investigate the link between human microbiota and SARS-CoV-2 susceptibility to further understand the viral pathogenesis.

scholarly journals Endoscopic Evaluation of Symptomatic Patients following Bariatric Surgery: A Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Miral Subhani ◽  
Kaleem Rizvon ◽  
Paul Mustacchia
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Drug Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Comorbid Conditions ◽  
Endoscopic Evaluation ◽  
Number Of Patients ◽  
Upper Gastrointestinal

Obesity is an epidemic in our society, and rates continue to rise, along with comorbid conditions associated with obesity. Unfortunately, obesity remains refractory to behavioral and drug therapy but has shown response to bariatric surgery. Not only can long-term weight loss be achieved, but a majority of patients have also shown improvement of the comorbid conditions associated with obesity. A rise in the use of surgical therapy for management of obesity presents a challenge with an increased number of patients with problems after bariatric surgery. It is important to be familiar with symptoms following bariatric surgery, such as nausea/vomiting, abdominal pain, dysphagia, and upper gastrointestinal bleeding and to utilize appropriate available tests for upper gastrointestinal tract pathology in the postoperative period.

Abstract 274: Prevalence of undiagnosed non-valvular atrial fibrillation in the United States

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Mintu P Turakhia ◽  
Jason Shafrin ◽  
Katalin Bognar ◽  
Jeffrey B Brown ◽  
Jeffrey Trocio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
The Elderly ◽  
The United States ◽  
Risk Scores ◽  
Chads2 Score ◽  
Aged Patients ◽  
Number Of Patients ◽  
Working Age ◽  
Back Calculation

Background: Because atrial fibrillation (AF) is often asymptomatic, clinically silent and therefore undiagnosed, the prevalence of AF is difficult to estimate. In fact, ischemic stroke is often the first clinical sign of AF among previously undiagnosed patients. In this study, we estimated the prevalence of undiagnosed AF using a back-calculation approach that relies on the fact that AF causes stroke but causality generally does not run from stroke to AF. Methods: We first estimated the prevalence of diagnosed non-valvular AF in the elderly (65+) and working age (18-64) U.S. population from a 5% Medicare sample and an OptumInsight commercial claims database from 2004-2010 using validated ICD9 algorithms. To estimate the prevalence of undiagnosed non-valvular AF, our back-calculation methodology used two measured inputs: (i) the number of patients who are diagnosed with new non-valvular AF in the current or subsequent quarter after a stroke; (ii) the probability that patients with non-valvular AF have a stroke, based on CHADS2 risk scores. We confirmed calibration by comparing our prevalence estimates of diagnosed AF with prior Medicare and commercial claims analyses. Results: Between 2005 and 2009, the estimated prevalence of AF gradually increased, reaching 9.9% of the elderly U.S. population and 0.88% of the working aged population by 2009. Among the Medicare AF cases in 2009, 11% of these cases (1.1% out of 9.9%) were undiagnosed; among working aged patients with AF, 8% of cases (0.07% out of 0.88%) were undiagnosed. In addition, a large share of the undiagnosed cases was at high risk of stroke. Among the undiagnosed AF cases for elderly and working age adults, 26% and 37%, respectively have a CHADS2 score of 1, and 68% and 26% have a CHADS2 score of 2+. Conclusions: Among elderly and working adult U.S. populations, a substantial proportion of individuals with undiagnosed AF have moderate to high risk of stroke. Screening for AF could favorably impact the disease burden.

Two Types of Anesthesia and Hemodynamic Changes in Patients Over 60 Years of Age Who Need Artificial Femoral Head Replacement: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Weiqi Ke ◽  
Yuting WANG ◽  
Xukeng GUO ◽  
Ronghua HUANG ◽  
Xiangdong ZHANG ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Femoral Head ◽  
Elderly Patients ◽  
The Elderly ◽  
Hemodynamic Changes ◽  
Medical College ◽  
Replacement Surgery ◽  
Elder Patients ◽  
Significant Difference ◽  
And Gender

Abstract Background:Artificial femoral head replacement is one of the most effective methods for treatment of severe diseases of femoral joint in the elderly. The ideal anesthetic effect is one of the key elements for the success of the operation because it brings fast recovery. However, the multiple comorbidities of the elder patients make them too weak to tolerate the hemodynamic changes after anesthesia. In this case, the most suitable anesthesia method for patients undergoing femoral head replacement surgery is of great significance.Objective:To compare the post-anesthetic hemodynamic changes between combined lumbar plexus and sciatic nerve block(CLPSB) and combined spinal and epidural anesthesia(CSEA) in elderly patients undergoing unilateral artificial femoral head replacement.Methods:We reviewed records of the patients who aged over 60 years old (age 62-103 years) and received unilateral artificial femoral head replacement between January 2015 and December 2020 in the first affiliated hospital of Shantou University Medical College. After adjustment according to the inclusion criteria, 477 patients were included and divided into CLPSB group (n=90) and CSEA group (n=387). The primary outcome was comparison of the hemodynamic changes after anesthesia, including the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). The second outcome was the comparison of the vasopressor used during the surgery.Results:We established three models to compare the two anesthesia methods on hemodynamic changes. Crude model included all variates for analysis, while model I adjusted age and gender. Model II adjusted other comorbidities in addition to model I. All three models exhibit that changes of MAP (∆MAP) after CSEA were higher than that after CLPSB(β= 6.88, 95% CI: 4.33 - 9.42, P < 0.0001), with significant difference, which indicated that CSEA causes higher fluctuation of MAP. Concurrently, the use of vasopressors increased by 137% (OR=2.37, 95%CI: 1.24-4.53, P=0.0091) in the CSEA group, which is statistically significant. However, the changes of HR (∆HR) between the CLPSB and CSEA was not significant(β= 0.50, 95% CI: 1.62 - 2.62, P = 0.6427). Conclusions:Both CLPSB and CSEA are ideal anesthesia methods for patients receiving femoral head eplacement, though CLPSB is more suitable for elderly patients with advanced hemodynamic stability.

scholarly journals Comminuted Patella Fracture in Elderly Patients: A Systematic Review and Case Report

2017 ◽  
Vol 8 (3) ◽  
pp. 135-144 ◽  
Author(s):  
Brent Matthews ◽  
Kaushik Hazratwala ◽  
Sergio Barroso-Rosa
Keyword(s):  
Case Report ◽  
Elderly Patients ◽  
Treatment Options ◽  
The Elderly ◽  
Fracture Pattern ◽  
Patella Fracture ◽  
Level Of Evidence ◽  
Fixation Failure ◽  
Number Of Patients ◽  
Mesh Augmentation

Objectives: To review comminuted patella fracture in the elderly patients and examine the surgical options to avoid complications such as fixation failure and poor functional outcome. To provide an example of mesh augmentation in comminuted patella fracture in the elderly patients. Data Sources: A literature review was conducted by the authors independently using Ovid, Medline, Cochrane, PubMed, and Clinical Key in English. We aimed to review data on patients older than 65 with comminuted patella fracture. Search conducted between July and December 2015. Study Selection: Search terms included patella fracture, elderly, and fixation failure. Abstracts were included if they were a case report, cohort series, or randomized control trial. Further inclusion criteria were that they were available in full text and included patient age(s), operative details, follow-up, and outcome discussion. Data Extraction: Each study was assessed according to its level of evidence, number of patients, age of patients, fracture patterns described, complications of treatment, and results summarized. Data Synthesis: Paucity of data and heterogeneity of studies limited statistical analysis. Data are presented as a review table with the key points summarized. Conclusion: In patella fracture, age >65 years and comminuted fracture pattern are predictors of increased fixation failure and postoperative stiffness, warranting special consideration. There is a trend toward improved functional outcomes when augmented fixation using mesh or plates is used in this group. Further level 1 studies are required to compare and validate new treatment options and compared them to standard surgical technique of tension band wire construct.

scholarly journals Palindromic rheumatism - an unusual Presentation of rheumatoid arthritis

2013 ◽  
Vol 22 (1) ◽  
pp. 93-95
Author(s):  
Sarmistha Biswas ◽  
Anonnya Rahman ◽  
Partha Pratim Das ◽  
Md Enamul Karim ◽  
Abed Hussain Khan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Joint Pain ◽  
Unusual Presentation ◽  
Palindromic Rheumatism ◽  
Medical College ◽  
Laboratory Investigations

We have reported a 24 years old woman presenting with recurrent episodes of joint pain, weakness and fever for last one and half year. Each episode persists for 3/4 days and intervals between episodes are variable. Laboratory investigations showed positive RF and anti-CCP. Each episode remits spontaneously with some NSAIDs. The case high lights the need of accepting Palindromic presentation of early Rheumatoid arthritis and it is not very rare as we think. DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15707 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 93-95

Major lupus organ involvement: severe lupus nephritis

Lupus ◽  
2010 ◽  
Vol 19 (12) ◽  
pp. 1391-1398 ◽  
Author(s):  
Y. Avihingsanon ◽  
N. Hirankarn
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Opportunistic Infections ◽  
Early Recognition ◽  
Asian Population ◽  
Immunosuppressive Drugs ◽  
First Episode ◽  
Asian Patients ◽  
Renal Flare ◽  
Number Of Patients

Lupus nephritis is a common and severe complication of systemic lupus erythematosus. A number of patients have nephritis as a presenting feature that, in its severe form, can shortly lead to end-stage renal disease and/or death. Renal flare usually occurs a few years after the first episode and is remarkably predominant in the Asian population. Frequent monitoring for renal flare enhances early recognition and timely treatment. The mainstay therapy continues to be the prolonged use of cytotoxic/immunosuppressive drugs that have a number of undesirable effects, particularly ovarian failure and development of opportunistic infections. This review will focus on the pathogenesis and the unique genetic factors found in Asian patients with lupus nephritis. Here, we propose an appropriate management scheme for the treatment of lupus nephritis in Asian patients.

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