Department Of Tertiary Care Center Research Articles

Profile of Patients Attending as Psychiatric Emergency at General Hospital

Introduction: Scaling of services in any area requires knowledge of the pattern of illnesses and their various presentations. We therefore conducted this study aiming to see the pattern of neuropsychiatric illness in an emergency department of tertiary care center. Methods: A prospective study was carried out to assess the pattern of psychiatric morbidity as well as pattern of presenting symptoms in the general emergency room services. Total 340 patients were sought for psychiatric consultation over a period of one and half years from Emergency Room of Tribhuvan University Teaching hospital, Kathmandu.Results: Out of these patients, 281 patients (82.7%) were found to have diagnosable psychiatric disorder. Most of the patients were in the age group of 31-40 years (25.6%), and from valley itself (56.2%).Males (55.9%) outnumbered females. Most common presenting symptoms were disturbed behavior and intentional self harm. Out of the patients who received the diagnosis of Category F- Mental and Behavioral disorders of the ICD-10 (82.7%), 26.8% were suffering from the Neurotic, stress-related and somatoform disorders and 26.5% were suffering from Mental and behavioral disorder due to psychoactive substance use. From the remaining 17.3% of patients, 14.1% of cases belonged to who attempted intentional self harm and rest were suffering from systemic disorder.Conclusion: Thus, this study emphasizes the importance of clinical and demographic characteristics of patients seeking psychiatric care in emergency service in order provide proper management.J Psychiatric Association of Nepal Vol .3, No.2, 2014, pp: 31-36DOI: http://dx.doi.org/10.3126/jpan.v3i2.12387

Clinical, bacteriological, and histopathological characteristics of children with leprosy: A retrospective, analytical study in dermatology outpatient department of tertiary care centre

Background: Leprosy is a major public-health problem in developing countries. According to National Leprosy Elimination Program report of March 2012, there were a total of about 0.13 million cases of leprosy in India, 9.7% of which were children. Studies pertaining to proportion and characteristics of pediatric cases are few in number. Aim: The aim of the following study is to examine clinical, bacteriological and histopathological characteristics of pediatric leprosy cases in community. Methods: A retrospective, analytical study of patients seen from 01 January 2009 to 30 June 2013 in dermatology out-patient department of tertiary care center in Mumbai, Maharashtra. Results: Study yielded 24 pediatric cases of leprosy. The age of child leprosy cases ranged from 3 to 12 years with mean of 9.25 ΁ 2.33. Most of the cases were multibacillary (MB) (95.8%). A large proportion of children (45.8%) had single skin lesion (SSL). Of the 11 SSL cases examined histopathologically, 8 (72.7%) showed features of borderline tuberculoid, 1 (9%) each of borderline lepromatous, indeterminate type and tuberculoid leprosy. Overall, one case had deformity (Grade 2) and 8.7% of MB cases were smear positive. Overall 2 patients had history of contact.Conclusion: The clinical, bacteriological and histopathological characteristics of cases in children, especially the high percentage of MB cases evidently indicate the grave nature of the problem of undetected child leprosy, recent active transmission and highlight implications on individual patients and the community.