scholarly journals Clinical Pattern and Frequency of Co-morbidities among Patients Presented with Cholelithiasis’ at Tertiary Care Hospital

Author(s):  
Juwereya Memon ◽  
Muhammad Jarwar ◽  
Sohail Ahmed Soomro ◽  
Abdul Sattar Memon ◽  
Riffat Jabeen Memon

Background: Gallstone disease (cholelithiasis) remains the commonest medical issue leading to surgical intervention. Causes of the Gall stone has been not properly understood, but it is thought to have several factors. Untreated gall stones can cause the various complications like inflammation of gall bladder, tissue damage, gallbladder tears and infection. Objective: To determine the clinical pattern and frequency of comorbidities among patients presented with cholelithiasis at Isra University Hospital Hyderabad, Pakistan. Materials and methods: This cross-sectional study was conducted at general Surgery department, Isra University Hospital, Hyderabad. All the patients having diagnosis of gall stone disease, age>18 years and either of gender were included in the study. Patients were selected on outpatient department (OPD) basis. Complete clinical examination was done including abdominal ultrasound and required laboratory investigations. Data regarding demographic information including clinical presentational and comorbidities like diabetes, hypertension and obesity was recorded and also smoking status was assessed. All the data was recorded via study proforma and was analyzed by SPSS version 20. Results: A total of 149 patients were studied, their mean age was 49.23+7.33 years. Females were commonest as 57(38.3%) and males were 92(61.7%). As per clinical presentation pain was found to be most common, particularly as epigastrium pain was found in (93.95%) cases, right Hypochondrium pain (73.82%), pain radiation was more towards scapula (50.33%), dyspepsia was noted in (49.66%), nausea was observed in 44 patients, flatulence in 45 patients and vomiting was least common (21.47%). Diabetes mellitus was 76(51.0%), hypertension was 67(45.0%), overweight were 63(42.3%), obese were 25(16.8%), HCV positive cases were 34(22.8%) and HBV positive cases were 09(59.7%). However smokers were 48(32.2%) and 06(4.0%) were alcohol consumers. Diabetes mellitus, hypertension and obesity were significantly more prevalent in females as compared to males (p=<0.05). Smoking habits and alcohol consumption were mostly found in males (p=<0.05). However HCV and HBV infections were statically insignificant according to gender. Conclusion: It was concluded that gallstone is a common problem and most of the patients who were diagnosed with gallstones were females, obese (BMI>27kg/m2), diabetes mellitus and belonged to fourth decade (40 to 50 years) of their life. Commonest clinical presentations were epigastrium pain, right Hypochondrium pain, pain radiation towards scapula and dyspepsia.

Author(s):  
Sujeet A. Divhare ◽  
Satyashil Ingale

Background: Potential importance of drug –drug interactions (DDIs) is increasing as polypharmacy becomes more prevalent. Because additional data on the incidence and pattern of potential DDIs among diabetic patients are lacking in India, and supplemental pharmacodynamic or clinical outcome information is needed to address importance of a drug- drug interaction. Aim and objectives: To identify and analyze the pattern of DDIs in patients being prescribed anti-diabetic drugs in a tertiary care hospital. Material and Methods: This prospective cross-sectional study was carried out for a period of three months in 200 Type 2 diabetes mellitus (Type 2 DM) patients who were taking at least one antidiabetic agent during the period of past six months, of any age and either sex admitted in medicine ward of a tertiary care teaching hospital. Only one prescription was included for each patient on his/her 3rd day of hospitalization in the ward. Results: A total of 1217 drugs were prescribed in 200 prescriptions, resulting in an average of 6.1 drugs per prescription. A total of 637 potential DDIs were noted. The majority were seen in middle aged and elderly people. No overall difference was detected in the patients on insulin or metformin therapy taking or not taking additional drugs with the potential to interact. Worse control was found in the group of patients on sulphonylurea therapy taking interacting drugs (P <0.05). This difference was most marked in the group of patients over 60 years of age, who also had the highest intake of potentially interacting drugs (57%; <35 years-37%). Conclusion: Antidiabetic drugs have numerous interactions. A good practice is to use a drug­–drug interaction checker if any questions arise, several are available online. Quality care starts with the clinician obtaining a complete medication list for each patient at the start of each visit. Keywords: diabetes mellitus, drug interactions, hypoglycemic agents, drug therapy, co-morbidity, polypharmacy


2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.


2020 ◽  
Vol 8 (1) ◽  
pp. 50-55
Author(s):  
Sanjay Chaudhary

Background and Objectives: Gallstone disease (GSD) is a chronic disease that consumes a lot of economic and medical resources. It not only affects patients’ life quality, but also is associated with the potential risks of the development of consequences of gallstone diseases. Therefore, the study is aimed to investigate the epidemiology and risk factors of gall stone diseases among patients attending tertiary care centre in Nepal. Material and Methods: A cross sectional study was conducted among patients attending surgical department of Janaki Medical College Teaching Hospital (JMCTH) over a period of one year from January 2019 to December 2019. Chi-square test was applied to show the association between the two groups. P-value < 0.05 was considered statistically significant. Results: In a total of 148 patients, 69.59% had mixed gallstone, 17.57% had cholesterol stone and 12.84% had pigment gallstone. Types of gallstone was found significant for age group (p=0.006), gender (p=0.027) and presence of diabetes (p=0.003) but insignificant with presence of hypertension (p=0.992). Conclusion: Age of the patients, gender and presence of diabetes were found significant for the all types of gall stone. Further large scale research need to be conducted.


2016 ◽  
Vol 04 (02) ◽  
pp. 133-136 ◽  
Author(s):  
Amit Thour ◽  
Ramninder Nagra ◽  
Arunjeet Gosal ◽  
Tejasav Sehrawat ◽  
Subhash Das ◽  
...  

Abstract Background: Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been limited data, especially from India, which has specifically examined whether diabetes mellitus is associated with an increased likelihood of comorbid anxiety. Aim: The aim was to estimate the prevalence of anxiety in patients with diabetes and to determine the association of anxiety with age, sex, and other related parameters. Setting: Endocrine clinic, tertiary care hospital. Design: Cross-sectional. Materials and Methods: The study was cross-sectional carried out in endocrinology clinic of tertiary care hospital in North India. Cases were patients with type 2 diabetes mellitus above 30 years of age. Anxiety was assessed using the generalized anxiety disorders 7-item (GADs-7) scale. The relationship with a sociodemographic profile, duration of diabetes, hypertension, and microvascular complications was also analyzed. Results: Seventy-three subjects (42.5% females) with mean age 50.8 ± 9.2 years were evaluated. The prevalence of anxiety was 34%. Severe anxiety (GAD-7 score ≥15) was present in three (4%) subjects, moderate anxiety (GAD-7 score ≥10) was present in six (8%) subjects, and mild anxiety was present in 16 (22%) of subjects. Anxiety increased with fasting plasma glucose, hypertension, was more in women, but the differences were not statistically significant. Conclusions: Our study demonstrates a higher prevalence of anxiety in patients with type 2 diabetes. No factor was significantly associated with anxiety. Therefore, anxiety should be assessed in each and every patient, irrespective of other factors.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fahad Hanif Khan ◽  
Raheela Hanif ◽  
Rumina Tabassum ◽  
Waris Qidwai ◽  
Kashmira Nanji

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9±10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.


2021 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Sumiya Bent Kalam ◽  
Sadia Islam ◽  
Mohammad Abdullah Az Zubayer Khan ◽  
Tanjina Akhter

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


2019 ◽  
Vol 2 (9) ◽  
pp. 217-222
Author(s):  
Kavya G ◽  
Mayur Nath T Reddy ◽  
Radhika Muthukuru

AIM: To assess the awareness of diabetic patients of their risk for oral disease as complication associated with diabetics. 
 INTRODUCTION: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to defective secretion or activity of insulin. Type II diabetes is a common disorder with concomitant oral manifestation that impacts dental care Evidence shows that many patients are unaware about effects of diabetes mellitus on oral health.  METHODOLOGY: A cross sectional descriptive survey was conducted among adult dental patients attending a tertiary care hospital of Bangalore city. A total of 172 patients were included in the study. The tool used to conduct the survey was a close-ended self-administered 14-item questionnaire. Self-rate oral health was assessed using a 4 point scale as good, average, bad and don’t know. RESULT: A total of 172 subjects, among them 120 (69.7%) were males and 52 (30.3%) were females. Among 172 subjects, 87(50%) were aware that diabetics are more prone to oral diseases .91(52%) of the study subjects did not know that diabetes effects gingiva.91(52%) of individuals knew diabetes causes delay in wound healing. 81% of the subjects, self-rated their mouth as good. CONCLUSION: Diabetic patients are less aware of their risk for dental diseases. Thus, it is necessary for dental professionals and related government agencies to promote awareness of the relationship between diabetes mellitus and oral health in order to prevent harmful complications on oral health


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