scholarly journals RELATIONSHIP OF D-DIMERS WITH THE DURATION OF CEREBRAL VENOUS SINUS THROMBOSIS (CVST): A DESCRIPTIVE STUDY IN TERTIARY HEALTH CARE HOSPITAL OF DISTRICT PESHAWAR PAKISTAN.

2021 ◽  
Vol 6 (3) ◽  
pp. 66-71
Author(s):  
Ayesha Zafar ◽  
Saima Abid ◽  
Fawad Ali ◽  
Mehtab Alam ◽  
Syed Zafar
Keyword(s):  
Magnetic Resonance ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Latex Agglutination ◽  
Care Hospital ◽  
Cross Sectional ◽  
Test Technique ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Subacute Stage

Purpose CVST is a serious condition with a recent incidence of 13 million persons per year. (1) It has a highly variable presentation and may manifest itself with no recognizable risk factor, Magnetic resonance venography (MRV) is the investigation of choice for its diagnosis. However, since MRV is not readily available and is costly, this study tried to find the relationship between the levels of D-dimers as marker and duration of CVST. D-dimers are degraded fibrin products which are found to be raised in pulmonary embolism and deep venous thrombosis. Methods: Total 49 patients (male to female ratio 1:6) mean age 36.37 13years) with MRV proven CVST were included in the study. This descriptive cross-sectional study was conducted from January 2015-April 2017, on 49 confirmed patients of CVST, in Lady Reading Hospital. In patients suspected of CVST, magnetic resonance imaging of the brain with MRV was performed without delay on a 1.5 tesla MR scanner using T1, T2, flair, and diffusion weighted imaging sequences with a two-dimensional time of flight MRV. D-dimers were estimated by a rapid latex agglutination slide test technique using monoclonal antibodies. Data was analyzed using SPSS version 19.  Frequencies, mean were calculated for quantitative data while Chi-square test was used for qualitative data. Sensitivity and specificity were calculated.  Result: The duration of symptoms was 3-60 days (mean 22 days). The mean value of D-dimers levels recorded in micrograms were recorded as 1456 Conclusion:  D-dimers levels were high in acute and subacute stage of CVST. However, there were cases in our study who despite having acute and subacute stage of CVST had normal D-dimers levels for unknown reasons.

scholarly journals Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

2021 ◽  
Vol 27 ◽  
pp. 107602962110228
Author(s):  
Bushra Moiz ◽  
Ronika Devi Ukrani ◽  
Aiman Arif ◽  
Inaara Akbar ◽  
Muhammed Wahhaab Sadiq ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Activated Protein C ◽  
Positive Association ◽  
Cerebral Venous Sinus Thrombosis ◽  
P Value ◽  
Middle Income ◽  
Duration Of Symptoms

Pediatric cerebral venous sinus thrombosis (CVST) is rare but a potentially fatal disease requiring its understanding in local setting. In this study, we observed the clinical course, management, and outcome of pediatric patients with sinus thrombosis in a tertiary care center at Pakistan. Patients between age 0 to 18 years of both genders diagnosed with sinus thrombosis during 2011 to 2020 were included. Data was collected through in-house computerized system and SPSS version 19 was used for analysis. Of 143492 pediatric admissions, 32 (21 males and 11 females) patients with a median (IQR) age of 4.5 years (0-16) had CVST. This is equivalent to 18.5 CVST events per million pediatric admissions. Adolescents were mostly affected, and the overall mortality was 7%. Primary underlying disorders were infections (59%), hematological neoplasms (12.5%), thrombotic thrombocytopenic purpura (3%) and antiphospholipid syndrome (3%). Activated protein C resistance (44%) was the most common inherited thrombophilia. Twenty-one (66%) patients were anemic with a mean (±SD) hemoglobin of 9.0 g/dL (±2.3). Regression analysis showed a positive association of anemia with multiple sinus involvement ( P-value 0.009) but not with duration of symptoms ( P-value 0.344), hospital stay ( P-value 0.466), age ( P-value 0.863) or gender ( P-value 0.542) of the patients. SARS-COV2 was negative in patients during 2020. Adolescents were primarily affected by sinus thrombosis and infections was the predominant risk factor for all age groups, with a low all-cause mortality. A high index of clinical suspicion is required for prompt diagnosis and intervention.

Safety and Validity of Mechanical Thrombectomy and Thrombolysis on Severe Cerebral Venous Sinus Thrombosis

Neurosurgery ◽  
2013 ◽  
Vol 72 (5) ◽  
pp. 730-738 ◽  
Author(s):  
Guangwen Li ◽  
Xianwei Zeng ◽  
Mohammed Hussain ◽  
Ran Meng ◽  
Yi Liu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Treatment Modality ◽  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Magnetic Resonance Venography ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Digital Subtract Angiography

Abstract BACKGROUND: Although the majority of patients with cerebral venous sinus thrombosis (CVST) obtain an optimistic clinical outcome after heparin or warfarin treatment, there remains a subgroup of patients who do not respond to conventional anticoagulation treatment. These patients, especially younger people, as documented by hospital-based studies, have a high morbidity and mortality rate. OBJECTIVE: To verify the safety and efficacy of a dual mechanical thrombectomy with thrombolysis treatment modality option in patients with severe CVST. METHODS: Fifty-two patients diagnosed with CVST were enrolled and treated with mechanical thrombectomy combined with thrombolysis. Patients underwent urokinase 100 to 1500 × 103 IU intravenous sinus injection via a jugular catheter after confirming diagnoses of CVST by using either magnetic resonance imaging/magnetic resonance venography or digital subtract angiography. Information obtained on the patients included recanalization status of venous sinuses as evaluated by magnetic resonance venography or digital subtract angiography at admission, during operation, and at 3- and 6-month follow-up after treatment. RESULTS: The percentage of patients that showed complete and partial recanalization were 87% and 6%, respectively, after mechanical thrombectomy combined with thrombolysis treatment; 8% of the patients showed no recanalization. The modified Rankin Scale scores were 1.0 ± 0.9, 0.85 ± 0.63, and 0.37 ± 0.53 for discharge, and 3- and 6-month follow-up, respectively. A total of 6 patients died despite receiving aggressive treatment. No cases of relapse occurred after 3 to 6 months of follow-up. CONCLUSION: Thrombectomy combined with thrombolysis is a safe and valid treatment modality to use in severe CVST cases or in intractable patients that have shown no adequate response to antithrombotic drugs.

scholarly journals Clinical and biochemical profile of obese and overweight children at a Tertiary Care Hospital.

2020 ◽  
Vol 27 (06) ◽  
pp. 1119-1123
Author(s):  
Asif Ali Khuhro ◽  
Fazal Ur Rehman ◽  
Waqas Ali ◽  
Najmi Usman ◽  
Sanam Bano Rajper
Keyword(s):  
Metabolic Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Biochemical Profile ◽  
Overweight Children ◽  
Cross Sectional ◽  
Female Ratio ◽  
Study Participants

Objectives: Childhood and adolescent obesity is increasing especially in developing countries like Pakistan. It seem to affect most socio-economic classes as well as all ethnicities and geographies. We planned this study to analyze the clinical and biochemical profile of obese as well as overweight children at a tertiary care hospital for the existence of metabolic syndrome. Study Design: Cross sectional study. Setting: Department of Pediatrics Medicine, Children Hospital Chandka Medical College / Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. Period: 1st July 2018 to 31st December 2018. Material & Methods: Children, aged 5 to 16 years, both gender, having BMI > 85th percentile regarding age and gender were enrolled. Demographic characteristics along with history, lifestyle parameters and physical examination were noted for all the study participants. Metabolic syndrome (Met S) was evaluated while overall results were presented in terms of proportions, mean and standard deviations. Results: A total of 78 cases were enrolled during the study period. There were 46 (58.9%) male and 32 (41.1%) female, with a male to female ratio of 1.4:1. Mean age amongst study participants was 10.8 years. We had 56 (71.8%) children as overweight whereas 22 (28.2%) obese. Acanthosis nigricans was the most common entity seen in 55 (70.1%) children during clinical examination. Metabolic syndrome was found to be present in 31 (39.7%) participants. Conclusion: Met S is not only limited to obese children as it can also affect children who are overweight.

Predictive Value of Combination of D-dimer and Fibrinogen in Diagnosing Acute CVST

2021 ◽  
pp. 097275312110631
Author(s):  
Abhishek Pathak ◽  
Varun Kumar Singh ◽  
Anand Kumar ◽  
Vijaya Nath Mishra ◽  
Deepika Joshi ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Predictive Value ◽  
Sinus Thrombosis ◽  
Care Center ◽  
Tertiary Care ◽  
Cerebral Venous Sinus Thrombosis ◽  
Latex Agglutination ◽  
D Dimer ◽  
Latex Agglutination Assay

Background: Cerebral venous sinus thrombosis (CVST) is an uncommon subtype of stroke, and the role of D-dimer and fibrinogen in early diagnosis of CVST has been studied with varying results. The present study aims to study the role of the combination of D-dimer and fibrinogen in early diagnosis of acute CVST. Methods: Forty consecutive confirmed acute CVST cases admitted at a tertiary care center were recruited for the study. D-dimer and fibrinogen were assessed by a rapid semiquantitative latex agglutination assay. Results: Out of the 40 CVST patients, 21 (52.50%) were females. The mean age of the patients was 37.58 years ± 19.17 years. Common clinical features were headache ( N = 38 [95%]), papilloedema ( N = 15 [37.5%]), and seizures ( N = 12 [30%]). Although the sensitivity (75%) of the combination of D-dimer and fibrinogen assay was lower than that of D-dimer or fibrinogen alone, the specificity and positive predictive value (75% each) was higher. Conclusions: The combination of D-dimer and fibrinogen testing may aid in an early diagnosis of acute CVST and in better management.

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
Keyword(s):  
Internal Medicine ◽  
Tertiary Care ◽  
Chronic Fatigue ◽  
Cross Sectional Study ◽  
National Language ◽  
P Value ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio

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  

scholarly journals Prevalence and correlates of psychological distress among cancer patients in a tertiary care hospital in northern India

2019 ◽  
Vol 6 (5) ◽  
pp. 2223 ◽  
Author(s):  
Amita Mason ◽  
Ruchi Juyal ◽  
Sai Chandan Das ◽  
Deep Shikha ◽  
Sunil Saini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Formal Education ◽  
Economic Status ◽  
Tertiary Care ◽  
Depression Scale ◽  
Care Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Female Patients

Background: Patients diagnosed with cancer are usually exposed to high level of mental stress and hence invariably lend in psychological distress. This study aimed to estimate the prevalence of psychological distress amongst cancer patients and determine its association with socio-demographic factors.Methods: This hospital based cross-sectional study was conducted at a cancer research institute of district Dehradun. Purposive sampling was used to select the hospital and recruiting patients. All eligible patients, giving written consent for the study were interviewed and distress related information was gathered using the Hospital Anxiety and Depression Scale (HADS). The data were collected for two months and sample size of 208 was achieved. Data was entered in SPSS 22.0 and association of different variables with psychological distress was determined by chi-square test..Results: The mean age of the surveyed cancer patients was 51.05±15.68 years and the male female ratio was 1.7. Prevalence of psychological distress was found to be 38.5% and significantly more female patients than male patients (47.4% and 33.3% respectively) had distress. The association between psychological distress and increasing age, sex, literacy and employment status was found to be significant.Conclusions: Approximately 39% of cancer patients had psychological distress (anxiety/ depression/ both). The prevalence of psychological distress was found to be significantly higher in female patients, older age, patients with no formal education, unemployment and lower socio-economic status. Appropriate psychiatric interventions/ counselling following diagnosis and during therapy may be effective in reducing distress and improving quality of life in cancer patients.

scholarly journals Clinical spectrum and outcome of extra-pulmonary tuberculosis in children.

2021 ◽  
Vol 28 (09) ◽  
pp. 1336-1340
Author(s):  
Asma Mushtaq ◽  
Aysha Mansoor Lodhi ◽  
Wajiha Rizwan ◽  
Carol Ruth ◽  
Meher Muzaffar ◽  
...  
Keyword(s):  
Weight Loss ◽  
Pulmonary Tuberculosis ◽  
Lymph Nodes ◽  
Tertiary Care ◽  
Clinical Spectrum ◽  
Care Hospital ◽  
Cross Sectional ◽  
Duration Of Symptoms ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary

Objective: To determine the types, clinical spectrum and outcome of Extra-Pulmonary Tuberculosis (EPTB) in children admitted at a tertiary care hospital. Study Design: Cross Sectional study. Setting: The Children's Hospital and The Institute of Child Health, Lahore. Period: May to December 2019. Material & Methods: A total of 63 patients diagnosed with EPTB aged 1 month to 16 years were included. All patients with lung involvement were excluded from the study. Anti-tuberculous therapy (ATT) was started in all patients and outcome was monitored during the hospital stay. Results: In a total of 63 patients, mean age was 9.03+3.1 years. There were 35 (55.5%) male and 28 (44.4%) female. The mean duration of symptoms at the time of presentation was 5.93+2.4 months. The common sites of EPTB were meninges noted in 17(26.9%), pleural in 13 (20.6%), abdominal in 12 (19.04%), lymph nodes in 11 (17.4%), disseminated in 6 (9.52%) and bone and joints in 4 (6.34%) patients. The most common systemic complaints were fever in 58 (92.06%), weight loss in 48 (76.1%) and anorexia in 45 (71.4%). After treatment, fifty-four patients improved and discharged while 9 (14.2%) patients died. Conclusion: The commonest sites of EPTB were meninges, pleural, abdomen and lymph nodes. Fever, weight loss and anorexia were the most frequent systemic complaints. Most of the patients recovered while the most common cause of mortality was tuberculous meningitis.

scholarly journals Multimorbidity Patterns Among Hospitalized Geriatric Patients in Medicine Wards of a Tertiary Care Hospital in Dhaka City

2021 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Sumiya Bent Kalam ◽  
Sadia Islam ◽  
Mohammad Abdullah Az Zubayer Khan ◽  
Tanjina Akhter
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College

Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59

scholarly journals Prevalence, knowledge, attitude and practice regarding self-medication among medical, dental and paramedical students in a tertiary care hospital

2018 ◽  
Vol 7 (9) ◽  
pp. 1822
Author(s):  
Madhulika Johnson ◽  
Dinesh Kumar Badyal
Keyword(s):  
Medical Students ◽  
Information Source ◽  
Tertiary Care ◽  
Common Symptom ◽  
Care Hospital ◽  
Self Medication ◽  
Cross Sectional ◽  
Female Ratio ◽  
Group A ◽  
Group B

Background: Self-medication is practiced universally. Having medical knowledge plays a vital role in its prevalence. It is more prevalent in higher education course students especially medical students. However, it is increasing in dental and paramedical students. Hence, this study was conducted to evaluate self-medication among medical, dental and para-medical students in a tertiary care hospital.Methods: A cross sectional questionnaire based study was conducted among 449 undergraduate students. They were divided into three groups. A questionnaire was developed based on literature. The questionnaire was validated and finalised. The paper questionnaire was administered to students. The data collected from questionnaires was analysed. The results were expressed as percentages and frequencies.Results: The male female ratio of students who filled questionnaire was 65:35. All the students (100%) reported that they practice self-medication. The most common reason for self-medication was prior experience (36%) in group A as well as in group B (46%), but in group C, 39% mentioned no serious problem. Main information source was family members in all the groups (A 57%, B 53%, C 29%) followed by advice from senior/friends. Fever was most common symptom reported (29%) by group A followed headache (28%) in group C and cough and cold (23%) in group B. The commonest group of drugs used is cough syrups (25%) in group B, followed by analgesics (23%) in group C and antipyretics (21%) in group A.Conclusions: Self-medication is growing among dental and paramedical students too. It is necessary to educate them about self-medication to prevent future disastrous consequences as well as to make them aware of appropriate use of self-medication.

Sign in / Sign up

Export Citation Format

Share Document