Increased frequency of fibromyalgia among patients with chronic pain presenting to internal medicine clinics of a tertiary care hospital: a cross sectional study

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Sana Javed ◽  
Muhammad Zaid ◽  
Sumera Imran ◽  
Ayesha Hai ◽  
Muhammad Junaid Patel

Objective: To estimate the frequency of patients with fibromyalgia (by using the 2010 Modified Criteria for Fibromyalgia by American College of Rheumatology ( ACR ) presenting to Internal Medicine clinics  Methods: A cross-sectional study conducted in the department of Internal Medicine, the Indus Hospital, khi, Pakistan between December 2016 and March 2018. Patients who visited internal medicine clinics, met the selection criteria, were included in the study. After taking informed consent patients were assessed for fibromyalgia according to the new 2010 Fibromyalgia Diagnostic criteria questionnaire. The patients were asked the questions in the national language, Urdu. Data analyzed using SPSS version 21. P value of < 0.05 was considered significant. Results: Of the 267 patients presenting to the internal medicine clinics and consenting for participating in the study 149 (55.80%) met at least one of the 2010 Fibromyalgia Criteria. The prevalence of fibromyalgia as estimated in this study was 56% with no difference in gender. Mean age of patients with fibromyalgia was 42.3 ± 14.6 and patients without fibromyalgia was 38.9 ± 13.7 which was statistically significant (p-value = 0.05, 10% level of significance). Of the 267 patient 197 (73.8%) were female and 70 (26.2%) were males, a male to female ratio of 1:2.81.  Conclusion: All patients with generalized pain should be evaluated for fibromyalgia and a diagnosis made to reduce the cost of further referrals and investigations and delay in the management of this debilitating disorder. Keywords: Fibromyalgia, Chronic fatigue, Generalized Pain  

2019 ◽  
Vol 6 (2) ◽  
pp. 371
Author(s):  
Nilesh S. Sonawane ◽  
Chaitanya R. Patil

Background: Tuberculosis is major public health problem especially in the low and middle income countries like India. We conducted a study to assess the knowledge, attitude and practice related to tuberculosis among the patients attending our tertiary care institute.Methods: A cross sectional study was conducted in a tertiary care hospital on the patients attending OPD of tertiary care hospital in Maharashtra. The patients with debilitating illness or bed bound patients and those diagnosed and cured of tuberculosis or were on treatment of tuberculosis were excluded from the study. A pretested and designed questionnaire was used to assess the knowledge, attitude and practice about the cause, clinical features and treatment of tuberculosis.Results: The mean age of the study subjects was 43.34±11.23 years with male: female ratio of 1.45. About 16.67% of the subjects stated that cause of TB is bacteria, 51.33% reported that cough was the most common symptom, 58.67% believed that it spreads from person to person and among the people who said it spreads 58.67% said that it can be preventable.Conclusions: About 1/5th of the study subjects expressed the cause of TB is bacteria or germs, and more than ½ believed that TB spreads from person to person. About 2/3rd of the patients felt that TB was a very serious disease; more than ½ of them expressed fear if they were diagnosed with TB but more than ½ of them also expressed rejection if they have a TB patient as a closed one.


Author(s):  
Manju Surendran ◽  
K Sunil Kumar

Introduction: Acute Upper Gastrointestinal (UGI) bleed is a common potentially life threatening emergency. The aetiological profile of bleed and prognosis varies according to geographical region and availability of endoscopic facilities. Aim: To determine the clinical and endoscopic profile of UGI bleed, risk factors and prognosis in the patients. Materials and Methods: This was a cross-sectional study conducted over a period of 12 months at a tertiary care centre in Southern India. Patients admitted with history of hematemesis and melena, satisfying the inclusion criteria was taken consecutively. Clinical and endoscopic profile were noted and followed-up for six weeks. Statistical analysis was performed using chi-square test for qualitative variables and independent t-test for quantitative variables. Significance level was fixed as p-value of <0.05. Results: A total of 138 patients were studied in this period. The male to female ratio in the study was 3.5:1. The mean age was 53.5±13.17 years. The most common clinical presentation was hematemesis in 57 patients (41.3%) followed by haematemesis and melena in 46 patients (33.3%). The most common cause on endoscopy was portal hypertension-related oesophageal and gastric varices (51.4%) followed by antral gastritis (15.2%). The cause of UGI bleeding could not be identified in 5.1% in which the endoscopy was normal. Haemogram, platelet count and serum albumin were significantly lower in variceal bleed group, compared to non-variceal group. Eleven patients succumbed to death secondary to UGI bleed. Conclusion: The most common causes of UGI bleed are portal hypertension related gastric and oesophageal varices. The in-hospital mortality in the study was 7.9%.


Author(s):  
Ashok Kumar ◽  
Geeta Yadav ◽  
Vijay Zutshi ◽  
Suman Bodat

Background: According to UNICEF, globally 800 million women die due to preventable causes related to pregnancy and childbirth; 20% of which occur in India. It is therefore imperative to understand the level of knowledge about danger signs among pregnant women to augment timely redressal of preventive obstetric causes of mortality.Methods: A hospital based, cross sectional study was conducted at the ANC Clinic in Safdarjung Hospital, New Delhi from 2nd July to 27th July 2018. Convenient sampling was used to identify and interview 354 pregnant women, using a semi structured questionnaire. Data was entered and analysed with SPSSv21. Results were presented as frequencies and proportions. Chi square was used to test for association between qualitative variables, and p-value less than 0.05 was considered significant.Results: 48.3%, 35.6%, and 40.1% of pregnant women had knowledge about danger signs during pregnancy, labour and postpartum respectively. Majority of the women had knowledge about abdominal pain (58.4%) and severe fatigue (80.7%) as danger signs of pregnancy, while bleeding (82.5%) was the most common response as danger sign of labour. More than half had knowledge about heavy bleeding (59.9%) as danger sign of postpartum. The women lacked awareness about Convulsions (92.9%) as danger signs of pregnancy and labour, as well as smelly vaginal discharge (79.6%) in postpartum.Conclusions: Knowledge of obstetric danger signs among pregnant women is still lower. It needs further awareness as it can help in early diagnosis and referral of patients thus reducing maternal mortality and morbidity.


2019 ◽  
Vol 6 (2) ◽  
pp. 329
Author(s):  
Venkatesha K. R. ◽  
R. Ravikumar Naik

Background: In the world, hunger and malnutrition are most significant threat. Malnutrition is global risk factor for significant death among infants and pregnant woman. malnutrition increases the chances of several infections.Methods: A cross sectional study was undertaken in children age group of 1 to 18 years, suffering from protein energy malnutrition, attending Department of Paediatrics, tertiary care hospital, Bangalore during the period January 2016 to December 2016. Results: In the present study, maximum number of cases (44) belongs to age group of 1-5 years, followed by 32 cases belongs to 6-12-year age group and 24 cases belong to 13-18-year age group. Maximum cases (59) belongs to female with male female ratio is 1:1.4. In the present study out of 100 cases, 81 cases came positive for protein energy malnutrition. Out of 81 cases positive for PEM, 34 cases belong to grade I followed by 24 cases belongs to grade II, 13 cases belong to grade III and 1o cases belongs to grade IV protein-energy malnutrition (PEM).Conclusions: Malnutrition is like an iceberg, most people in the developing countries live under the burden of malnutrition.


2019 ◽  
Vol 57 (220) ◽  
Author(s):  
Kripa Rajak ◽  
Anu Radha Twayana ◽  
Rashmi Shrestha ◽  
Puja Amatya ◽  
Calvin Ghimire

Introduction: Kawasaki disease is an acute vasculitis of unknown etiology. The epidemiological data available for Nepal remains insufficient. In Nepal, Kawasaki disease has only been reported in cases of brief reports, leaving the true disease burden unknown. Many cases go undiagnosed and untreated due to a lack of knowledge regarding this entity. The objective of this study was to find the prevalence of Kawasaki disease in a tertiary care hospital. Methods: This descriptive cross-sectional study was carried out in a tertiary care hospital of Nepal from 2013 to 2018 after taking ethical approval from the Institutional Review Committee. The sample size was calculated and the consecutive sampling method was done. Data collection and entry was done in Microsoft Excel, point estimate at 99% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The overall prevalence of Kawasaki disease was found to be 0.1% among 11,416 patients under the age of 5 years admitted in pediatrics ward. There were 4 (33.33%) cases of complete Kawasaki and 8 (66.67%) cases of incomplete Kawasaki. There were 9 (75%) males and 3 (25%) females and the male to female ratio was 3:1. There was a male preponderance. The age at diagnosis ranged between 4 and 60 months. The median age at diagnosis was 10.5 months. The most common presentation was fever, conjunctivitis, rash, and oral changes. Conclusions: Prevalence of Kawasaki disease was found to be lesser compared to other studies done in other countries. Knowledge of Kawasaki disease among Nepalese pediatricians should be enhanced to guarantee the appropriate diagnosis and treatment of this disease.


2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Roshan Ghimire ◽  
Ashik Rajak ◽  
Dhiresh Maharjan ◽  
Prabin Thapa

Introduction: Superior mesenteric artery first pancreaticoduodenectomy is being increasingly used for pancreatic head and peri-ampullary tumors. The aim of our study was to determine the frequency of various approaches of superior mesenteric artery pancreaticoduodenectomy along with its postoperative complications in a tertiary care center. Methods: This is a descriptive cross-sectional study of patients undergoing superior mesenteric artery first pancreaticoduodenectomy with different approaches conducted at Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal, from May 2018 to April 2020. Ethical approval was taken from the Institutional Review Committee (reference no: 310520193). The whole sampling method was adopted. Thirty-four patients undergoing a superior mesenteric artery first pancreaticoduodenectomy at our center with different approaches were included in the study. The data analysis was done in the Statistical Package for the Social Sciences version 20. Results: For 34 patients chosen for the study, the male: female ratio was 1.6:1, with a mean age of 53.7 years. The medial uncinate approach was done in the majority of the cases, 26 (76.4%), whereas the inferior infracolic (mesenteric) approach was done in 1 (2.9%) case. Regarding postoperative complications, Clavien Dindo grade 3 and grade 4 were present in 11 (32.3%) patients, pancreatic fistula (Grade B and C) was observed in 6 (17.6%) patients, and mortality occurred in 2 (5.8%). The mean hospital stay was 16±9 days. Conclusions: Superior mesenteric artery first pancreaticoduodenectomy with a different approach can be performed with acceptable morbidity and mortality. Early determination of resectibility is achieved in selected cases.


Author(s):  
Manjaree Morgaonkar ◽  
Ramesh Kushwaha ◽  
Savera Gupta ◽  
Suresh Kumar Jain ◽  
Dattatray V. Kulkarni ◽  
...  

<p class="abstract"><strong>Background:</strong> Psoriasis, a common skin disorder is now considered as systemic inflammatory disease. Its chronic inflammatory state is thought to predispose patients to metabolic syndrome (MetS), which is a significant predictor of cardiovascular events. The objective of the study is to investigate the prevalence of metabolic syndrome in psoriatic patients with only cutaneous involvement and to evaluate the correlation between presence of MetS and psoriasis severity</p><p class="abstract"><strong>Methods:</strong> We performed hospital based, cross-sectional study on 100 adult patients with psoriasis vulgaris and equi-numbered age and sex matched controls. MetS was diagnosed by revised National Cholesterol Education Program’s Adult Panel III criteria.</p><p class="abstract"><strong>Results:</strong> A higher prevalence of metabolic syndrome was found in psoriasis patients as compared to controls [28 (28%) vs 9 (9%), P value=0.0005].Impaired fasting glucose level, hypertension, hypertriglyceridemia and abdominal obesity were more prevalent in psoriasis group. No statistically significant difference was found between prevalence of low levels of HDL and presence of metabolic syndrome. Presence of metabolic syndrome was not associated with severity and duration of psoriasis. Female patients with psoriasis were more frequently having metabolic syndrome.</p><strong>Conclusions:</strong> Prevalence of metabolic syndrome is higher in patients with psoriasis irrespective of its duration and severity. This stresses on the need of regular evaluation for the presence of MetS or any of its components in psoriasis patients so as to allow early detection and management.


2018 ◽  
Vol 8 (3) ◽  
pp. 170-173
Author(s):  
Zulfiqar Ali Shaikh ◽  
Javeria Shamim ◽  
Kelash Nankani

Background: Hepatitis C is among one of the major global health issues; which may cause chronic liver disease, end stage liver disease, and hepatocellular carcinoma; subsequently requiring liver transplant. For HCV, standard treatment is a combination therapy of ribavirin and interferon for six months. Ribavirin fostered hemolysis is a major treatment-associated adverse effect. Our study aimed to assess ribavirin induced anemia among Hepatitis C patients visiting Civil Hospital, Karachi. Methods: A hospital-based cross-sectional study which included 106 Hepatitis C patients, of 15-60 years' age, visiting CHK, a public sector tertiary care hospital, from October 2017 to January 2018 by using non-probability convenient sampling technique. Results: Total 106 patients participated, 53 (50.0%) were males and 53 (50.0%) were females. Mean (±SD) age was 37.05 (±10.793). Mean (±SD) duration of ribavirin use was 3.03 (±1.523) months. Around 16.0% had ribavirin dose reduction. All of them experienced weakness, fatigue and light-headedness, 59.4% developed microcytic hypochromic anemia, 23.6% had severe anemia. Mean (±SD) hemoglobin level before the onset of treatment was 12.78 (±1.555). Mean hemoglobin level during treatment was 10.72g/dL. Mean reduction in hemoglobin levels was 2.07g/dL. The reduction in hemoglobin levels and the duration of therapy were correlated (p-value <0.05). The severity of anemia was related to age of the patients (p-value <0.05) but not with gender and RBC morphology. Conclusion: Ribavirin induces anemia. The duration of ribavirin therapy and initial hemoglobin levels were related to the severity of anemia, significant enough to cause dose modification and subsequently suboptimal levels affecting efficacy. In return hemoglobin reduction, dose modification and age of the patient were also related.


2021 ◽  
Vol 15 (11) ◽  
pp. 2989-2992
Author(s):  
Abdul Haadi ◽  
Sidra Ishfaq ◽  
Munazza Nazir ◽  
Syed M.Sajid Ali Bukhari ◽  
Muhammad Ishraf-Ul-Islam ◽  
...  

Background: Evidence available on atrial fibrillation in Pakistan is not enough. Therefore, present study aims to determine frequency of atrial fibrillation and its associated complications. Place and duration of study: This cross sectional study was conducted at Department of Medicine, at SKBZ/AK CMH Muzaffarabad (Tertiary Care Hospital Muzaffarabad AJK) from July to December, 2019. Methodology: Total 1100 patients included for this study through non-probability consecutive sampling. Ethical approval and consent forms were taken. Patients were examined for atrial fibrillation through ECG. The patients who were confirmed as AF were detail examined and their cause and complications were noted down. Data was analyzed with SPSS version 24. One sample t test was used to predict AF in the population Chi-square test was applied. P value ≤0.05 was considered significant. Results: Out of 1100 patients mean age of patients was 43.4±12.7 years. The male to female ratio was 11:10. The atrial fibrillation was diagnosed in 250 (22.7%). In our population, at least 20% of the patients are having issue of atrial fibrillation with p value 0.016. The percentage of AF was higher in female 40.4% as compared to male 6.9%. Similarly the percentage of AF was higher in hypertensive patients (37.8%) as compared to non-hypertensive patients (12.3%). Conclusion:The prevalence of atrial fibrillation is moderately high in our data. Our sample results support the hypothesis that female are mostly with AF. Hence there is need to take measures to prevent them. Keywords: Atrial fibrillation, Causes of atrial fibrillation, Complications of atrial fibrillation


2019 ◽  
Vol 6 (2) ◽  
pp. 526
Author(s):  
Mote Srikanth ◽  
Jeyapalan Kuppusamy ◽  
Hemachandar Radhakrishnan ◽  
Arun Prasath Palamalai

Background: Chronic kidney disease is distinguished by progressive loss of kidney function over a period of years in the end leading to irreversible kidney failure. CKD is a significant prognosticator of cardiovascular disease. Atherosclerosis is common in patients with risk factors associated with chronic kidney disease.Methods: It was a cross sectional study on CKD patients in a tertiary care hospital. About 90 CKD stage 3-5 patients aged above 18 years were enrolled in the study. Serum lipid profile, RFT, serum calcium, phosphorous, and BP were estimated among all the patient. Patient risk factors were noted and CIMT levels were compared accordingly.Results: Out of 90 patients, males were predominant. There was a significant positive correlation between stage 5 and CIMT (P value <0.001). Mean CIMT was higher in patients with type 2 Diabetes. Patients with higher phosphorous the mean CIMT was significantly higher.Conclusions: The CIMT is early marker for atherosclerosis. Author observed it was significantly higher in patients with stage 3 and 5 CKD. CIMT is a non- invasive marker which should be done in all patients with CKD which is cost effective.


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