Cost of Ambulatory Care in Diabetes: Findings From a Non-Communicable Disease Clinic of a Tertiary Care Institute in Eastern India

Abstract Background The presence of psychiatric illness among patients with physical illnesses leads to poor treatment adherence, poor lifestyle, increased cost of treatment, poor quality of life, worsening of physical illness, work absenteeism, increased hospital visits, poor self-care and higher mortality. The study evaluated the prevalence of cognitive impairment and psychiatric morbidity in non-communicable disease patients. The study highlights that NCD patients should be provided information about the development of cognitive impairment in order to prevent it. Methods It was a cross-sectional study conducted among the patients attending the non-communicable disease clinic of a rural community health centre run in collaboration with the Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh. We registered 124 patients after obtaining written informed consent. Instruments: Hindi Mental Status Examination (HMSE), Patient Health Questionnaire-9, Generalized anxiety disorder-7 (GAD-7) scale. Analysis of covariance was applied to see the relationship between the domain of the HMSE and NCDs. Results The mean age of the participants was 55.5 years (SD-11.9, Range-26-90). A little more than one third (N = 48, 38.7%) were diagnosed with hypertension only, one-sixth (N = 22; 17.7%) were diagnosed with diabetes mellitus only, and 54 (43.5%) patients were diagnosed with both hypertension and diabetes mellitus. A slightly more than one-third of the study participants were diagnosed with depressive disorder (N = 44, 35.5%), and 29% (N = 36) of the participants were diagnosed with an anxiety disorder. About one-fourth of patients with NCD have cognitive impairment and 39.51% have psychiatric morbidity. Conclusions The prevalence of cognitive impairment is higher among patients of NCD with psychiatric morbidity. Patients with NCDs should be routinely screened for cognitive functioning and provided information about the development of cognitive impairment. Key messages Because of high prevalence of cognitive impairment and psychiatric morbidity in NCD patients, patients should be provided information to prevent it. There is a need to screen NCD patients routinely for cognitive functioning, and provide them information to prevent cognitive impairment.

Download Full-text

Pattern of HIV infected meningitis patient investigated in a tertiary care institute of eastern India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20190180 ◽

2019 ◽

Vol 6 (2) ◽

pp. 623

Author(s):

Rajib Saha ◽

Chandrima Saha

Keyword(s):

Cell Count ◽

Cryptococcal Meningitis ◽

Tertiary Care ◽

Secondary Data ◽

Cross Sectional Study ◽

Eastern India ◽

Chi Square ◽

Cross Sectional ◽

Cd4 Cell Count ◽

Care Institute

Background: This study was started in the aim of determining the pattern of meningitis and their clinico-laboratorial presentation among HIV infected patients.Methods: This secondary data based cross-sectional study was conducted on 2010 in a tertiary care institute of eastern India among HIV infected meningitis patients. From June 2009 to May 2010, 92 patients were included in our study. Bed head tickets, laboratory reports and registers were used for data collection. Chi square test was applied for the test of significance.Results: 70.7% cryptococcal and 29.3% tubercular meningitis cases were found. Mean CD4 cell count, CSF protein, CSF glucose, WBC cell count of TB and cryptococcal meningitis patients were 143 cells/cumm, 546.1 mg/dl, 26.8 mg/dl, 550 cells/ cumm and 175 cells/ cumm, 189.1 mg/dl, 30.1 mg/dl, 36 cells/ cumm respectively. 29.2% patients of Cryptococcal meningitis were presented with mental change, confusion or psychological disorders, but these symptoms were not observed among TB meningitis patients.Conclusions: This study provided a baseline data about epidemiology and clino-laboratorial features of HIV meningitis patients of eastern India and will help for further investigation in this field.

Download Full-text

Drug utilization pattern in type II diabetes mellitus patients attending non-communicable disease clinic in a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20190662 ◽

2019 ◽

Vol 8 (3) ◽

pp. 539

Author(s):

Akash Gadgade ◽

Shwetha B. ◽

Basavaraj C. Kotinatiot ◽

Chetan A. C.

Keyword(s):

Diabetes Mellitus ◽

Drug Utilization ◽

Communicable Disease ◽

Fixed Dose ◽

Care Hospital ◽

Antidiabetic Drug ◽

Disease Clinic ◽

History Of ◽

Comorbid Diseases ◽

Non Communicable Disease

Background: Diabetes mellitus is a metabolic disorder. Early institution of treatment is necessary to prevent complications. Since treatment of diabetes requires lifetime therapy; this study is designed to understand the prescription trends at Non Communicable Disease clinic set up and to provide rationale.Methods: This cross-sectional, observational study was conducted over a period of 2 months (May 2017- June 2017). Details of demographic data, duration and family history of diabetes, antidiabetic medications prescribed, history of comorbid diseases and drugs prescribed by physician for the treatment of comorbid diseases were collected in a structured format. Height and weight were recorded, and body mass index was calculated.Results: Study population included 294 patients and patients in the age groups of 40-59 years formed the bulk. 39% patients were overweight and 19.39% were obese. 93.20% patients were prescribed with metformin. 37 patients received insulin injection. 64.29% received more than one antidiabetic drug. Hypertension (82.05%) was the most common comorbid disease. Amlodipine was the most commonly prescribed antihypertensive drug.Conclusions: Metformin was the most commonly prescribed antidiabetic drug. Utilization of newer antidiabetic drug is inferior. Use of rationale fixed dose combination improves patient compliance.

Download Full-text