Attending Tertiary Care Research Articles

Characteristics of Etiological Factors Related to Tinnitus in Patients Attending Tertiary Care Hospital in DMCH, Darbhanga

Characteristics of Etiological Factors Related to Tinnitus in Patients Attending Tertiary Care Hospital in DMCH, Darbhanga

Clinico-social Profile of Animal Bite Cases Attending Tertiary Care Teaching Hospital in Maharashtra, India

Introduction: Rabies is primarily a communicable zoonotic disease of warm blooded animals particularly carnivores, such as dogs, cats, jackals & wolves. It is an acute highly viral disease which affects the central nervous system. It is the only communicable disease of man that is always fatal. Objective: To study the clinico-social profile of animal bite cases attending tertiary care teaching hospital in Maharashtra. Method: A hospital based observational descriptive study was conducted amongst 6050 patients of animal bite coming to the ARV OPD from 1st January 2014 to 31st December 2014 in tertiary care teaching hospital in Maharashtra. Results: In the present study, majority cases 3467(57.3%) were males, 2843 (47%) were in the age group of 21 to 40 years. There were 4647(76.8%) unprovoked, 4127(68.2%) category III and 4780(79%) by non observable animals bites. Most common site 4962(82%) was extremities. Maximum 2602(43%) cases reported to ARV OPD within 24 hours of animal bite. Only 320(5.3%) cases have taken proper wound care (washing with water and soap) as compared to 3206 (53%) cases who had taken no home management for wound care. Active immunization (anti-rabies vaccine) was administered to 6001(99.2%) of cases and passive immunization with anti-rabies serum (ARS) was advised in all 4126(68.2%) of category III patients. Conclusion: Study concludes that patients should be made aware of immediate reporting of animal bites, importance of proper care of wound and necessity of taking ARV and ARS. Information, Education and Communication activities should be facilitated to promote public awareness about the prevention and treatment of animal bite cases.

Genetic diversity and phylogenetic analysis of Crimean-Congo Hemorrhagic Fever viruses circulating in Pakistan during 2019.

Being an endemic country for Crimean Congo hemorrhagic fever (CCHF), this study aimed to explore the genetic diversity of CCHF virus (CCHFV) detected in Pakistan during 2019. Serum samples from patients with clinical signs of hemorrhagic fever attending tertiary care hospitals in Pakistan were tested for CCHFV RNA using real-time PCR at Department of Virology, National Institute of Health. The partial S-gene fragments were directly sequenced to determine the prevailing CCHFV genotypes and their molecular epidemiology in Pakistan. During January-December 2019, 280 samples from suspected CCHF patients were tested and 28 (10%) were found positive on real-time PCR. Positive cases were detected from 14 districts and across all four provinces of Pakistan with majority reported during August-September. The mean age of CCHFV positive patients was 37.25 years (range 5–65 years) with a high frequency in males (92.8%; n = 26) and a case fatality rate of 40.7% was observed. Phylogenetic analysis showed that S- segment of 2019 PAK CCHFV strains (n = 13) belonged to Asia-1 genotype and clustered with regional strains from Iran, Oman, and Afghanistan. We conclude that Asia-1 genotype of CCHF virus remains endemic in Pakistan. Our findings emphasize to establish a laboratory based surveillance program to monitor the disease burden and identify outbreak hotspots for effective control.

Patient Level Delay in Diagnosis of Multi-Drug Resistant Tuberculosis among Patients Attending Tertiary Care Hospital in Haryana

Background: Multi-Drug Resistant Tuberculosis (MDR-TB) besides increasing cost and duration of treatment also increases the mortality and morbidity. Less awareness in the community and diagnostic constraints for MDR-TB at patient level is a major cause of delay in diagnosis. Objective: To find out the delay in diagnosis of MDR-TB and factors affecting this delay among MDR-TB patients attending tertiary care hospital, PGIMS Rohtak, Haryana, India. Material and Methods: It is a hospital based cross-sectional study carried out in the department of Respiratory Medicine, PGIMS Rohtak, Haryana from March 2018 to February 2019 among 125 admitted patients of MDR-TB in tertiary care hospital, PGIMS Rohtak. A pre-designed, pre-tested, semi-structured interview schedule was used and data were analysed using SPSS version 20.0 and Chi square test was applied. Result: The mean and median patient delay was found to be 31.11 days and 21 days, respectively. Extent of patient delay was significantly associated with socio-demographic factors like age, sex, literacy status, occupation, addiction and past history of TB in patients. Conclusion: In this study, it was concluded that there was significant delay in the diagnosis as well as seeking treatment at patient level which was associated with socio-demographic factors. Thus, there is urgent need to boost up the Information, Education and Communication (IEC) activities to increase awareness among general public about the importance of early diagnosis and treatment of MDR-TB.   How to cite this article:Jain RB, Gupta R, Sharma S, Kumar T, Agrawal G, Choudhary P et al. Patient Level Delay in Diagnosis of Multi-Drug Resistant Tuberculosis among Patients Attending Tertiary Care Hospital in Haryana. Epidem Int 2019; 4(4): 8-15. DOI: https://doi.org/10.24321/2455.7048.201918

To study the epidemiology and clinical profile of adult patients with acute abdominal pain attending tertiary care hospital

Introduction: Acute abdomen is a very common problem in emergency department. Aims and Objectives: This study aims to find out the clinical and epidemiology profile of acute abdominal pain among patients attending emergency department of Santosh Medical College Ghaziabad. Materials and Methods: A tertiary care hospital based, cross-sectional study was conducted from January 2018- April 2019 2018, among patients presenting with acute abdominal pain to Santosh Medical College Ghaziabad, India. Data was entered on a standard data collection sheet after obtaining a written informed consent. Results: Out of 1200 patients admitted via the Emergency Department at the Hospital, 200 (16.6%) were admitted with atraumatic acute abdominal pain. Out of 200, 120(60%) were due to Surgical causes and 80 due to non-surgical causes. Most consistent symptom and sign were pain abdomen and abdominal tenderness respectively. Acute cholecystitis was the most common etiology of acute abdominal pain (35.8% cases), followed by, Renal Stones (30.5%), Acute Appendicitis (17.5%) and Intestinal Obstruction (16.67%) respectively. Conclusion: About 16.60% of all emergency admissions were due to acute abdominal pain and about 60.0% of all atraumatic acute abdominal pain was due to surgical cause. Acute cholecystitis was the most common cause of surgical abdominal pain. Keywords: Acute abdominal pain (AAP), Right hypochondrium (RHC), Epigastrium, Hypochondrium.

Assessment of Risk Factors of Breast Cancer among Women Attending Tertiary Care Hospital of CHATTISGARH: a Case Control Study

Breast cancer is a multifactorial disease. This study was undertaken to study various risk factors associated with breast cancer. This was a case control study conducted between August 2017 to August 2018 at Department of surgery, Dr.B.R.A.M Hospital and Pt.JNM Medical college, Raipur, (C.G.). Cases were women with histopathologically confirmed breast cancer. Controls were age-matched women without any current breast problem or previous breast cancer. A total of 138 cases and 138 controls were enrolled. They were interviewed for menstrual history, breast feeding history, abortion history, family history etc. after obtaining informed written consent. The significant risk factors were age > 25 years at first child birth (OR 2.80, 95%CI 1.13–6.95), breast feeding history of 25 years, breast feeding duration of <2 years, history of abortion and comorbidities increases the risk of developing breast cancer.

A cross-sectional study of co-morbid generalized anxiety disorder and major depressive disorder in patients with tension-type headache attending tertiary health care centre in central rural India.

Tension-type headache (TTH) is one of the most common reasons patients seek medical treatment. Psychiatric co-morbidities such as anxiety and depression have been commonly observed in patients with TTH. The objective was to study the prevalence and severity of co-morbid generalized anxiety disorder (GAD) and major depressive disorder (MDD) in patients with TTH. The present cross-sectional study was conducted in the Tertiary Health Care Centre in Central Rural India, with a sample size of 85. Data were recorded in the predesigned, semi-structured questionnaire. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HDRS) were used to categorise the co-morbid anxiety and depression. About 48.2% of the study participants were in the age group of 31-40 years with a mean age of 36.8 ± 7.1 years. Higher proportions of female study participants (64.7%) were observed. Majority of the study participants were literate (76.5%), employed (57.7%), married (78.8%) and had rural residence (54.1%). The prevalence of co-morbid GAD was 70.6%, whereas the prevalence of co-morbid MDD was 54.1%. According to HAM-A, 31.8% had mild, 21.2% had moderate, while 17.6% had severe anxiety levels. According to HDRS, 34.1% had mild, 16.5% had moderate and 3.5% had severe co-morbid depression. TTH is frequently associated with co-morbid GAD and MDD.

Physical and psychosocial concerns among patient living with implantable cardioverter defibrillator attending tertiary health care facility

Physical and psychosocial concerns among patient living with implantable cardioverter defibrillator attending tertiary health care facility

Case control study of renal function in patients with hypothyroidism attending tertiary care hospital

Case control study of renal function in patients with hypothyroidism attending tertiary care hospital

A cross-sectional survey to assess the awareness among patients with type 2 diabetes mellitus attending tertiary care hospital in East Godavari region, India

Background: The burden of Type 2 diabetes mellitus (T2DM) is increasing rapidly in India. Knowledge regarding this will play a crucial role in its prevention and control. Objective: The present survey was conducted to assess awareness on various aspects of diabetes among T2DM patients. Materials and Methods: This was a cross-sectional study done among Type2 diabetes mellitus patients. Group 1 comprised 120 newly diagnosed cases while Group 2 comprised 120 old cases with

A Study of Lipid Profile Abnormalities among Patients with Essential Hypertension Attending Tertiary Care Centre

A Study of Lipid Profile Abnormalities among Patients with Essential Hypertension Attending Tertiary Care Centre

Psychiatric morbidity in patients suffering from psoriasis attending tertiary care hospital

Psychiatric morbidity in patients suffering from psoriasis attending tertiary care hospital

Prevalence and correlates of depressive symptoms among people living with HIV attending tertiary care hospitals in Oman.

Introductiondepressive symptoms have been widely reported among people living with HIV (PLHIV) around the world. The extent of this on PLHIV in the Arabian Peninsula is unclear. This study aims to examine the prevalence of depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) in adult Omani patients with HIV attending a tertiary care hospital. It also aims to investigate the relationship between clinical and socio-demographic variables and depressive symptoms.MethodsLHIV, age >18 (n=101), participated in the study who were followed up at a teaching hospital in Muscat, Oman. Participants were identified by a convenient and consecutive sampling of eligible patients who came for consultation on the days that the investigator conducted recruitment. The presence of depressive symptoms was quantified by the Patient Healthcare Questionnaire-9 (PHQ-9). Various socio-demographic backgrounds and risk factors will be also sought as well as activities of daily living (ADL). Chi-square test, Fisher´s exact test, t-test and logistic regression were used to explore which variables were associated with patients having depressive symptoms.Resultsthe prevalence rate of depressive symptoms in this cohort was 41.6%. Depression among PLHIV was found to be significantly associated with age (p <0.001), HIV disease duration (p <0.001), total dependency for ADL (p <0.001) and comorbid hypertension (p <0.001).Conclusiondepressive symptoms are common in Omani patients living with HIV. HIV care providers are urged to be vigilant to recognize depressive symptoms in these mood-vulnerable populations and to call for a multidisciplinary team with mental health professionals, for the prevention and treatment of depressive symptoms among PLHIV in Oman.

Comorbidity of unipolar depression in patients of vitiligo attending tertiary care hospital

Background: Vitiligo is one of the most common dermatological illnesses with localized depigmentation leading to cosmetic impairment. This also causes impairment of physical, psychological, social functioning of individual which in turn leads to psychiatric morbidities such as anxiety and depression. Aims and Objective: The present hospital based study was carried out to evaluate the presence of depression in patients of vitiligo patients in their different socio demographic variables. In addition, attempts were made to measure the severity of depression in those patients. Material and Methods: This was a hospital based cross-sectional study. Eighty patients of vitiligo with lesions in the exposed body parts were enrolled for the study after their informed consent with purposive sampling method from the Department of Dermatology, in a tertiary care hospital in north eastern part of India and compared them with those of healthy control. Those patients were evaluated by using ICD-10 research criteria and 17 item Hamilton rating scale of depression to diagnose and grade the degree of depression. Data were collected and “Chi Square Test” or “Fisher Exact t Test” was used. Mean value and standard deviation were calculated. All analysis were done using SPSS version 20.0. Results: Co morbidity of depression was significantly higher in vitiligo group (23.75%) in comparison to control group (6.25%). Among the depressed patients 68.43% had mild depression and 31.57% had moderate depression. Depression was inversely proportional to the years of education. Conclusions: These findings indicate the need of early recognition of depression among these patients and their early intervention, which will improve the primary disease process positively.

Nicotine Dependence, Readiness to Change Behavior among Tobacco Users Attending Tertiary Care Hospital's De-Addiction Clinic in Uttarakhand

Introduction: Tobacco use is a significant cause of many respiratory diseases and preventable deaths in India. The crunch of information on the magnitude of the tobacco use problem unable to planned and implement tobacco cessation programs in the Himalayan region. This study aims to determine nicotine dependence and readiness to change behavior in tobacco users attending a tertiary care teaching hospital's de-addiction clinic. Materials and Methods: This descriptive study purposively included 120 tobacco users over 6 months in a public hospital's de-addiction clinic, North India. A structured personal and clinical profile sheet, the Fagerstrom Test for Nicotine Dependence-Revised Version-smokable and smokeless), and Readiness to Change Questionnaire (RCQ) were used to collect information. Descriptive and inferential statistics were used to generate the findings. Results: The mean age of tobacco initiation was 20.69 (±6.12) years in the study population, with a median ofthree quit attempts (median: 3; interquartile range: 2–5). Nearly 55.8% and 18.3% of participants were using smokable and smokeless tobacco, respectively. Bidi was the most preferred (75.8%) form of smokable tobacco among study participants. The majority of participants were in the category of high nicotine dependence (76.6%) as per the FTND scale and were in the contemplation phase (55%), whereas 45% of the users found it in the action stage of quitting tobacco. Conclusions: The majority of the participants were in the high nicotine dependence stage. However, readiness to change behavior to quit or reduce tobacco use is noteworthy, emphasizing need-based intervention and assisted follow-up programs to tobacco users in the outpatients.

Metabolic Parameter and Insulin Resistance in Non Alcoholic Fatty Liver Disease Patient Attending Tertiary Care Hospital Coastal Andhra Pradesh

Metabolic Parameter and Insulin Resistance in Non Alcoholic Fatty Liver Disease Patient Attending Tertiary Care Hospital Coastal Andhra Pradesh

Delays in Diagnosis of Cervical Cancer Among Women Attending Tertiary Care Cancer Diagnostic Hospitals in Bhubaneswar, India

Cervical cancer is one of the major causes of cancer deaths among women worldwide, with > 85% of the global burden of these cases and deaths occurring in developing countries. Delay in diagnosis of cervical cancer negatively impacts the prognosis and quality of life. The purpose of the study was to assess the different types of delays in cervical cancer diagnosis and identify the factors associated with the diagnostic delays. This cross-sectional study was undertaken in tertiary care cancer diagnostic hospitals of Bhubaneswar, the capital city of state Odisha during February–June 2018 including 122 women diagnosed with cervical cancer by histopathological examination. The mean age of the study respondents was 52.1 ± 10.9 years. The median total diagnostic delay was 68 days, and 48 (39.3%) patients had delayed diagnosis of cervical cancer. Among all the components, patient delay was the major contributor to the diagnostic delay. Multivariable analysis revealed that variables like lower education status of husband, patient’s positive history of sexually transmitted disease, non-attendance of screening program and not performing cervical/per speculum examination during initial consultation were significantly associated with longer diagnostic delays. There is an urgent need to shorten the diagnostic journey of the cervical cancer patients by addressing all the components of diagnostic delay and developing strategies to modify the factors associated with these delays.

Cutaneous Bacteriological Profile and its Antibiotics Sensitivity Pattern in Patients of Pemphigus Vulgaris Attending Tertiary Care Hospital, Jamnagar, India

Cutaneous Bacteriological Profile and its Antibiotics Sensitivity Pattern in Patients of Pemphigus Vulgaris Attending Tertiary Care Hospital, Jamnagar, India

An evaluation of health-related quality of life and its determinants among people living with HIV/AIDS attending tertiary care hospital of Kurnool, India

Background: HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. Combined with ART, Quality of life (QoL) is an important component in the evaluation of the wellbeing of people living with HIV/AIDS (PLHIV). The objective of this study is to assess health related quality of life of HIV/AIDS patients attending ART clinic Tertiary care hospital, GGH, Kurnool and to determine the association of socio-demographic and disease related variables with health related quality of life.Methods: A cross-sectional study was conducted from April 2019 to June 2019 involving 400 purposively selected HIV-positive patients of age &gt;18 years, who were taking highly active anti-retroviral therapy for the past 6months from the ART center, GGH, Kurnool. After obtaining IEC clearance and informed consent, WHOQOL-BREF instrument was used for data collection. Data analysis was performed using IBM SPSS version 26.0.Results: Out of the 400 participants, 60% were males. The mean age of the participants was 38.5±10.54 years. Overall quality of life had a mean score of 69.71. Physical (82.57) and level of independence (78.78) domains showed higher mean score when compared to psychological (63.82), environmental (61.49) and Social (60.26) domains.Conclusions: Among study subjects 15.5% had excellent QoL (≥80), nearly 69.75% had good QoL (60-79) and 14.75% had poor QoL (&lt;60). Low QoL scores were seen in the social domain, suggesting that more social interventions are required in this population.

An Epidemiological Study of Traumatic Head Injury in a Tertiary Care Center in Kancheepuram, Tamil Nadu, India

Introduction: Traumatic brain injury is a major public health problem in India. The severity of a traumatic brain injury may range from mild to severe. The increase in economic growth in India coupled with rise in population, motorization and industrialization has contributed to a significant increase in TBI with each advancing year. India having the highest rate of head injury in the world. In India more than 100000 lives are lost every year with over 1 million suffering from serious head injury.&#x0D; Objectives: To assess the risk factors among for head injury cases and assess the outcome of the traumatic brain injury patients.&#x0D; Materials and Methods: A cross sectional Study conducted among all patients with traumatic head injury attending tertiary care centre and those admitted in intensive care unit with the history of traumatic head injury for the duration of one year (August 2016 to July 2017). Data was collected through questionnaire, hospital records and collected from patients. Data Collected was entered in MS office excel and analyzed in SPSS version 21.&#x0D; Results: Totally 295 cases were reported with history of traumatic brain injury, out of which 82.7% were males and 17.3% were females. Road traffic accidents was the most common cause for TBI 86.4%. Most of the patient was between the age group of 21-40 (51.5%). Most of the cases were from rural areas 55.3%. Based on GCS 49.5%, 28.5% and 22.0% patients had mild, moderate and severe injury respectively. 44.7% injuries occurred between the time period 04.00PM to 12.00AM.&#x0D; Conclusion: This study revealed that most traumatic head injury occur due to Road traffic accident stressing the urgent need to create awareness and conduct health education about prevention of traumatic head injury.