scholarly journals An Observational Study of Stroke and its Outcomes in a Tertiary Care Hospital

2020 ◽  
Author(s):  
Amruth Gujjar ◽  
Rekha Walwekar ◽  
AN Dattatri
Keyword(s):  
Drug Therapy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Clinical History ◽  
Haemorrhagic Stroke ◽  
Developed Countries ◽  
P Value ◽  
Care Hospital ◽  
Case Record

Introduction: Incidence of stroke is higher in developing countries than in developed countries. India shows prevalence of Cerebrovascular Disease (CVD) in the range of 52 to 843/100,000 population. Stroke causes 9% deaths around the world. The basic principle of managing stroke includes making an accurate diagnosis, choosing the effective drugs and dose for the stroke type. Aim: To analyse the outcomes of pharmacotherapy of stroke based on characteristics and clinical presentation of patients admitted to hospital and to know the adverse effect of drugs used. Materials and Methods: This cohort study was conducted with Department of Medicine and Neurology at Karnataka Institute of Medical Sciences, Hubballi from January 2015 to December 2015. After clearance from Institutional Ethics Committee, 162 cases were selected based on the inclusion and exclusion criteria. The clinical history, in examination modified Rankin score (mRS) at admission, discharge and on follow-up were recorded. The criteria for selecting the drugs, frequency, dosing, duration and change in drug therapy were recorded. The efficacy of drug therapy was assessed by clinical improvement. The adverse events were assessed and recorded. The patients were followed-up at three and six months. The data were entered after defining the variables in SPSS (version 16) from case record form. Descriptive statistics were used to summarise baseline data. Results: Of the 162 patients, 155 completed the six months follow-up. The median age of patients was 60 years for ischaemic and 55 years for haemorrhagic stroke. More males were admitted with strokes {108 (69.67%)} compared to females {47 (30.32%)}; 130 (83.87%) patients had ischaemic strokes, 16 (10.30%) haemorrhagic stroke {15 (9.67%) were intracerebral haemorrhage + 1 (0.63 %) patient had a subarachnoid haemorrhage}, 9 (5.8%) had Transient Ischaemic Attack (TIA). The modified Rankin score calculated for the patients was statistically significant between admission and discharge (1.29, p-value 0.0035), and that between three months and six months (0.9, p-value 0.003) of follow-up.Total 93% of 121 patients with ischaemic stroke received antiplatelet therapy. Amlodipine was the most commonly prescribed antihypertensive. Conclusion: Pharmacotherapy of stroke in the study was evidence-based and satisfactory. However, patients showed reduced compliance to all medications. Clinical presentation and type of stroke were important predictors of morbidity and mortality at the end of six months.

scholarly journals Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1007
Author(s):  
Vijoy S. Kairi ◽  
Pinaki Chakravarty ◽  
Arun Kumar Sipani
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Case Record ◽  
Medical College ◽  
Disease Modifying ◽  
Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

scholarly journals A comparative study of the efficacy of amisulpride and olanzapine in patients with schizophrenia attending the outpatient Department of Psychiatry in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (2) ◽  
pp. 284
Author(s):  
Ali N. Yashin ◽  
Dolly Roy ◽  
Prosenjit Ghosh
Keyword(s):  
Atypical Antipsychotics ◽  
Rating Scale ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Brief Psychiatric Rating Scale ◽  
Parallel Group ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

Background: Schizophrenia is one of the most commonly encountered psychiatric disorders. It is characterized by impairment in perception or expression of reality, leading to occupational and social dysfunction. Now a day’s mainstay of treatment of schizophrenia is by using atypical antipsychotics. Amisulpride and olanzapine are atypical antipsychotics which are commonly used in treatment of schizophrenia. The current study is undertaken to assess the efficacy of amisulpride which is a relatively newer antipsychotics against existing antipsychotic olanzapine.Methods: This was designed as a single-blind, prospective, parallel-group, observational study. Eighty adult patients of either sex were randomized to receive standard doses of the two drugs orally for 12 weeks, with follow up at 4 and 8 weeks. Effectiveness was assessed by change in the score of Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) score during the treatment period. Data were entered in Microsoft excel and statistical analysis were done using graph pad and p value <0.05 considered to be statistically significant.Results: Out of 80 adults patients 76 patients were evaluated by dividing into two groups, 38 patients were included in each group. Final BPRS score was less for olanzapine as compared to amisulpride (p<0.001). Improvement in CGI score is more in olanzapine group than amisulpride group which became statistically significant from 8th weeks onwards.Conclusions: Both amisulpride and olanzapine are very effective in controlling the symptoms of schizophrenia which is evident by significant decrease in BPRS, CGI-S and CGI-I score, but efficacy of amisulpride is still inferior to olanzapine.

Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

2019 ◽  
Vol 30 (2) ◽  
pp. 163-171
Author(s):  
Amod Tilak ◽  
Smita Shenoy ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Amruta Tripathy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
P Value ◽  
Care Hospital ◽  
Long Term Treatment ◽  
Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

scholarly journals Outcomes of Squint Surgery in Terms of Motor Alignment within 10 Prism Diopters in a Tertiary Care Hospital: A Clinical Audit

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Shaukat Ali Chhipa ◽  
Sharmeen Akram ◽  
Asma Rahman
Keyword(s):  
Tertiary Care Hospital ◽  
Clinical Audit ◽  
Tertiary Care ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Age And Gender ◽  
Squint Surgery ◽  
And Gender

Purpose:  To determine the outcome of squint surgery in terms of motor ocular alignment within 10 prism diopters, in a tertiary care hospital. Study Design:  A clinical audit at a tertiary care hospital. Place and Duration of Study:  The study was conducted in Ophthalmology department, of Aga khan university hospital, Karachi between December 2016 and June 2017. Methods:  Medical records of all patients who underwent squint surgery were retrieved and included in the study. Patients with amblyopia, corneal or retinal pathologies and those who lost to follow-up or with incomplete records were excluded. All the available demographic and clinical data including pre-operative visual acuity, squint measurements, procedure performed and post-operative ocular alignment up to maximum of 6 months of follow-up was compiled. Results:  One hundred and nineteen patients fulfilled the inclusion criteria. There were 54.6% males and 45.4% were females. Squint was unilateral in 75.4% of patients and bilateral in 24.5%. Exotropia was present in 74 (62%) and Esotropia in 45 (38%) patients. The frequency of post-operative outcomes among the study participants were analyzed and it was reported that at six months follow-up central straight eye position or squint less than 10 prism diopters was seen among 75.5% of patients. The association of age and gender with primary outcome was obtained by applying independent sample T test. All the categories of age and gender showed statistically significant results i.e. p-value ? 0.05, except one week follow-up among different categories of gender showing insignificant results with p value = 0.740. Conclusion:  In present study 75.5% patients achieved the required result of ocular alignment within 10 prism diopters of orthotropia at the final follow-up visit. Key Words:  Squint, Esotropia, Exotropia, 10 prism Diopters.

scholarly journals Prospective study on prescribing pattern of antihypertensive drugs at a tertiary care hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 2126
Author(s):  
Vishwanath M. ◽  
Murgesh J. V. ◽  
Arpitha D. ◽  
Nithiya D.
Keyword(s):  
Drug Therapy ◽  
Tertiary Care Hospital ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Case Record ◽  
Health Maintenance ◽  
Number Of Patients ◽  
Wide Range

Background: Hypertension is the leading non-communicable disease risk attributing to cardio vascular morbidity and mortality. Various reasons are socio-economic, behavioural, sedentary life style, nutritional, age, obesity and poor health maintenance. A wide range of antihypertensive drugs belonging to different pharmacological classes are available alone or in combinations. Present study was done to evaluate the prescribing pattern of antihypertensive drugs at a tertiary care hospital.Methods: A prospective, observational, non-interventional, hospital-based study was carried out in hypertensive patients attending outpatient department of General Medicine at Medical College Hospital attached to Vijayanagar Institute of Medical Sciences, Ballari. Data was collected from outpatient slip of patients in a predesigned case record form, which was analysed using descriptive statistics.Results: Among 200 patients analysed 95 (47.5%) were males and 105 (52.5%) were females, with maximum number of patients falling in the age group 61-70years. Among antihypertensives prescribed, amlodipine (78.5%) was most frequently prescribed drug. Frequently used drugs for monotherapy - amlodipine (37.5%), for two drug therapy - amlodipine + atenolol (25.5%), and for three drug therapy - amlodipine + atenolol + telmisartan (2.5%). WHO prescribing indicators: Average number of drugs per encounter is 2.38 (±1.19). Percentage of drugs prescribed by generic name is 76.47%. Percentage of drugs prescribed from essential drug list is 97.89%.Conclusions: Present study shows current trends in prescription of antihypertensives in tertiary care hospital and their rational use. Study emphasizes need for preventive and educative measures about hypertension in population.

scholarly journals Study of association between characteristics of patient and likelihood of benzodiazepine use in psychiatry outpatient department at tertiary care hospital of Kathmandu

2017 ◽  
Vol 7 (3) ◽  
pp. 13-20
Author(s):  
Binod Raut ◽  
Anjan Khadka ◽  
Pradeep Manandhar ◽  
Kamal Kandel
Keyword(s):  
Drug Therapy ◽  
Tertiary Care Hospital ◽  
Muscle Relaxation ◽  
Tertiary Care ◽  
Study Drug ◽  
Developed Countries ◽  
Outpatient Department ◽  
Care Hospital ◽  
Cross Sectional ◽  
Benzodiazepine Use

Introduction: Benzodiazepines exert their pharmacological properties as hypnotics, anxiolytics, anticonvulsants and muscle relaxants. Benzodiazepines are clinically effective for a number of indication including the reduction of anxiety, the induction and maintenance of sleep, muscle relaxation. They have a range of well documented adverse effects that may outweigh the benefits in certain patient population including psychomotor impairment, development of tolerance and dependence, potential for abuse. Methods: It is a hospital based prospective cross-sectional study conducted in a psychiatry outpatient department of tertiary care hospital. All the patients attended to the outpatient department of psychiatry and prescribed with benzodiazepine were selected for study. Drug therapy details in medication chart review and clinical review in patients treated with benzodiazepines was analyzed to measure the utilization pattern of benzodiazepines in terms of patient characteristics (e.g. age, gender and marital status), occupation, education and diagnosis, number of prescription of benzodiazepines, their doses, frequency, routes of administration and duration of use in each patient. Results: Out of a total of 384 patients, 246 of the patients had been currently using at least one benzodiazepine. Prevalence of benzodiazepine use was 64%. There was statistically significant association between benzodiazepines use with gender distribution, occupation and education. The prevalence of benzodiazepines use is relatively higher than that reported in the developed countries. Clonazepam was the most widely used benzodiazepine followed by lorazepam. Conclusion: The study evaluated the association between characteristics of patient and likelihood of benzodiazepines use. This will definitely help to optimize the drug therapy, improve the quality of care and reduce the negative outcomes in the usage of benzodiazepines.

scholarly journals A STUDY ONCYTOPENIAS AND THE FACTORS ASSOCIATED WITH CYTOPENIAS AMONG HIV INFECTED PATIENTS ADMITTED AT A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 9 (08) ◽  
pp. 172-179
Author(s):  
Manju Rose Sebastian ◽  
Seena Sankar ◽  
Mary George
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Prevalence Ratio ◽  
Developed Countries ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Hiv Patients ◽  
Factors Associated

Introduction: India has the third highest burden of HIV in the world. Haematological complications are common in HIV patients, of which cytopenias are the most frequently encountered. The cytopenias have been found to adversely affect the outcome of HIV patients with greater mortality and decreased quality of life. Aims and Objective: To assess the prevalence of cytopenias among patients admitted in a tertiary care hospital and to assess the factors associated with the cytopenias. Materials and Methods: The present study was conducted in the department of general medicine at a tertiary care hospital and 191 patients admitted in the hospital during the study period were taken for the study. The baseline investigations at the time of admission were taken into consideration. Patients were interviewed and charts reviewed to collect the data. The data collected was analysed with SPSS-2018. Continuous variables were expressed as mean +/- standard deviation and as median and interquartile ranges as appropriate. Categorical variables were expressed as percentages and frequencies. Comparisons between data was done by student’s t test and chi square. The factors associated with various cytopenias was assessed using log binomial regression. A p value of < 0.05 was taken as significant. Results: The overall prevalence of any cytopenia was found to be 85.9%. The most common cytopenia was anaemia with a prevalence of 78.5% followed by thrombocytopenia and leucopenia with prevalences of 28.8% and 24.1% respectively. Anaemia was found to be more prevalent among females with a prevalence ratio of 3.05 (95% CI: 1.39- 10.16, p value 0.009) when compared to males. The most common cause of anaemia was found to be B12 deficiency. There was significant association between leucopenia and CDC staging with the prevalence of leucopenia being higher among patient with CDC stage 3. [Prevalence ratio:1.46 (95% CI 0.67-3.17, p 0.024)]. No significant association was found with gender, duration of HIV, ART regimen, CDC stage or presence of opportunistic infections and thrombocytopenia. Conclusion: The prevalence of cytopenias among HIV patients was found to high – 85.9% especially compared to other developed countries. The most common cytopenia among the patients was found to be anaemia with a prevalence of 78%. The next most common cytopenia was thrombocytopenia, followed by leucopenia. The factors associated with these cytopenias can help to screen for patients at higher risk of developing these cytopenias and hence establish preventive strategies against them.

scholarly journals Association of ABO blood groups with dengue fever and its complications in a tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 265-269 ◽  
Author(s):  
Shivani Ravichandran ◽  
S. R. Ramya ◽  
Reba Kanungo
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Blood Group ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Blood Groups ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Case Record

Abstract CONTEXT: Dengue fever (DF) has been steadily increasing in India with outbreaks in certain areas taking the proportion of epidemics. Along with secondary dengue, several risk factors predispose to dengue hemorrhagic fever and dengue shock syndrome. Very few studies associating the relationship between dengue and its severity with ABO blood group have been documented. AIMS: The aim of this study was to determine the association between distribution of ABO Rh blood groups and DF and DF with thrombocytopenia. SETTINGS AND DESIGN: This was a retrospective descriptive study conducted at the clinical laboratory of the department of microbiology. MATERIALS AND METHODS: Dengue patients whose case record contained information on blood group were screened for details of blood group and confirmed dengue diagnosis. Randomly 384 case records were selected. These were divided into two groups; Group 1 included DF cases (platelet count >20,000) and Group 2 included DF cases with thrombocytopenia (platelet count <20,000). Control group consisted of patients other than dengue, whose blood grouping had been done; randomly 390 were selected and analyzed. STATISTICAL ANALYSIS USED: P value was calculated using the Chi-square test. Odds ratio were calculated using the Fisher's exact test. RESULTS: DF was higher in 23% of individuals with AB blood group as compared to 8.5% of controls (P = 0.0004), whereas patients with blood group O were significantly less affected with DF (P = 0.0048). Disease severity was not associated with any of the blood groups. CONCLUSIONS: Individuals with AB blood group are more prone to DF, whereas individuals with blood group O are less prone.

scholarly journals Primary Nasal Tuberculosis: Resurgence or Coincidence − A Report of Four Cases with Review of Literature

2017 ◽  
Vol 9 (01) ◽  
pp. 026-030 ◽  
Author(s):  
Sabina Khan ◽  
Mukta Pujani ◽  
Sujata Jetley
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Female Ratio ◽  
Antituberculous Treatment ◽  
Hematoxylin And Eosin ◽  
Hematoxylin And Eosin Stain ◽  
Male To Female

ABSTRACT Background: Primary nasal tuberculosis (TB) is a rare form of TB even in areas with high TB incidence. It is timely diagnosis and proper management are often delayed due to its rarity and nonspecific clinical presentation. Aim: The aim of the study was to review histopathologically diagnosed cases of nasal TB over a period of 1 year and to describe its clinical presentation, diagnostic workup, the importance of histopathological diagnosis along with a brief review of the literature. Materials and Methods: This was a retrospective study done in the Department of Pathology of a Tertiary Care Hospital of Delhi over a period of 1 year where all the cases with histopathological diagnosis of nasal TB were reviewed. Patients’ clinical details, investigations and treatment details along with follow‑up were obtained from the medical records section. For each case, routine hematoxylin and eosin stain were studied along with Ziehl–Neelson staining. Results: A total of four patients were diagnosed with nasal TB histopathologically. Patients’ age ranged from 5 to 34 with an equal male to female ratio. All patients were immunocompetent. Primary nasal TB was seen in all of the four cases. None of the cases, it was clinically suspected, and histopathology was the mainstay of diagnosis. All the cases were treated with antituberculous treatment and showed considerable improvement. Conclusions: Although nasal TB is rare, it should be considered in the differential diagnosis of chronic nasal symptoms and granulomatous lesions of the nose. Histopathology plays an important role in the diagnosis of these clinically unsuspecting cases of nasal TB.

Sign in / Sign up

Export Citation Format

Share Document