Faizan Qaisar1*, Mohsin Shafi1, Ayesha Majeed1, DileepKumar1, Awais Memon1and Umer Memon1
1Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro,
Sindh, Pakistan
A Point Cross-sectional study of Swine Flu Cases admitted at a Tertiary Level Hospital, Jaipur (Rajasthan) India-Presently in India Swine Flu cases were reported maximum from Rajasthan in this year (2015). So this study was aimed to analyzed the swine flu cases on various grounds to know the reasons for this increase. 77 swine flu cases addimited on 10.3.15 in a tertiary level hospital were interrogated. Total 2603 swine flu cases and 101 deaths were confirmed upto 10.3.15 in this current year concluding CFR 3.88%. Mean age of identified 77 swine flu cases was 41.32 ± 16.19 years with age range 1.5 to 75 years and MF ratio 0.51. Significantly more females were affected with swine flu than males but no significant age wise difference was found in males and females. Out of total 77 cases, 32.47 % were in ICU. About one third (31%) were self motivated others were from government and private health institutes. They were correctly diagnosed symptomatically in 33.77% before referred and about half of cases were advised for investigation (44.16%) for swine flu and precautions (51.95%) regarding respiratory antiquates. And 63.64% were admitted within 24 hours shows good awareness. Co morbidity was found in 57.14% of admitted cases and maximum (84%) co morbidity was found in cases admitted in ICU.
Evaluation of Anti-Retroviral Combination Therapy In Patients With HIV/Aids I...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
A Point Cross-sectional study of Swine Flu Cases admitted at a Tertiary Level Hospital, Jaipur (Rajasthan) India-Presently in India Swine Flu cases were reported maximum from Rajasthan in this year (2015). So this study was aimed to analyzed the swine flu cases on various grounds to know the reasons for this increase. 77 swine flu cases addimited on 10.3.15 in a tertiary level hospital were interrogated. Total 2603 swine flu cases and 101 deaths were confirmed upto 10.3.15 in this current year concluding CFR 3.88%. Mean age of identified 77 swine flu cases was 41.32 ± 16.19 years with age range 1.5 to 75 years and MF ratio 0.51. Significantly more females were affected with swine flu than males but no significant age wise difference was found in males and females. Out of total 77 cases, 32.47 % were in ICU. About one third (31%) were self motivated others were from government and private health institutes. They were correctly diagnosed symptomatically in 33.77% before referred and about half of cases were advised for investigation (44.16%) for swine flu and precautions (51.95%) regarding respiratory antiquates. And 63.64% were admitted within 24 hours shows good awareness. Co morbidity was found in 57.14% of admitted cases and maximum (84%) co morbidity was found in cases admitted in ICU.
Evaluation of Anti-Retroviral Combination Therapy In Patients With HIV/Aids I...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Household disposal of pharmaceuticals” a risk to the environment (A SURVEY)Gulzar Alam
The presence of pharmaceuticals are the nearly ubiquitous pollutants in both ground and surface waters environment, has become a cause for increasing concern in recent years. This study aimed to investigate the household disposal of unused and expired pharmaceuticals as a source of pharmaceuticals in the environment. The survey was carried out in major cities i.e. Ahemedabad, Gandhi Nagar, Amreli, Rajkot, and Vadodra of Gujarat state. We used the information on when and how they disposed of unfinished pharmaceuticals to construct a conceptual model to assess the pathways of pharmaceuticals into the environment. The model demonstrated that disposal of unused pharmaceuticals, either by household waste or via the sink or toilet, may be a prominent route that requires greater attention. This survey reveals important data regarding awareness, economics and other aspects regarding the use of household pharmaceuticals. So, overall conclusion of survey that the household disposal of pharmaceuticals among peoples in different place in Gujarat is very harmful for the environment and human health. Keywords: Pharmaceuticals, Pollutants, Household Disposal, Sink or Toilet
Association of CD4 T cell Recovery and Interpersonal Trust in Patient Physici...ijtsrd
The global HIV AIDS pandemic is still dangerous due to high incidence and high mortality rate. There are many factors associated with the immunological response beside treatment with medical practice. This paper aimed to assess the correlation of immunological responses and trust in physician measures in adult patients living with HIV AIDS. A cross sectional was studied to find the association between CD4 T cell changes and interpersonal trust in patient physician relationships. This study was carried out 93 aldult patients male accounted for 83.9 who were newly diagnosed with HIV AIDS infection at outpatient clinics, Tropical Diseases Hospital from October 2018 to August 2019. The mean TCD4 increased by 324.7 cells µl and 379.7 cells µl, respectively, compared to the original of 161.7 cells µl. Almost all patients had their immunity recovered after 3 and 6 months and the majority of patients have achieved virological success after 6 months of treatment. Factors associated with early immune recovery are youth, lower secondary education and single status. The majority of patients had truly trust in physician after 1 month and factors associated with trust in physician scale are male and employed. In Spearman rank correlation, CD4 T cell recovery and the trust present a strong relationship with p=0.008. Our finding is that the initial immunity recovery was strongly influenced by the interpersonal trust between the patients and the healthcare workers. Tao Gia Phu | Nguyen Hoang Lam | Cao Ngoc Nga | Vo Van Tam | Nguyen Phan Trong Hieu | Nguyen Van Trung "Association of CD4 T cell Recovery and Interpersonal Trust in Patient-Physician Relationship among HIV-Infected Adults in Hospital for Tropical Diseases, Vietnam" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30752.pdf Paper Url :https://www.ijtsrd.com/medicine/other/30752/association-of-cd4-t-cell-recovery-and-interpersonal-trust-in-patientphysician-relationship-among-hivinfected-adults-in-hospital-for-tropical-diseases-vietnam/tao-gia-phu
Molecular epidemiology is an emerging branch of epidemiology developed by merging molecular biology into epidemiological studies. Molecular epidemiology studies identify infectious diseases’ causation and pathogenesis and unravel infectious agents’ sources, reservoirs, circulation pattern, transmission pattern, transmission probability, and transmission order. Molecular epidemiology, an area of epidemiology that is somewhat ambiguous, encompasses utilization of biomarkers and genetics as tools to define both exposures (factors that are inherited) and outcomes (factors that are acquired). In last few decades, it has grown extensively to help to understand of disease ecology, in planning disease control, and in drafting health policies.
A study on prescription pattern and rational use of statins in tertiary care ...SriramNagarajan16
Objectives
Our objectives are to evaluate prescription pattern and rational use of statins in a tertiary care corporate hospital.
Methodology
It was a prospective observational study conducted for a period of 6 months and included various departments of 300
bedded multi specialty tertiary care corporate hospital. A total of 200 patients were included and the study criteria
was inpatients and induvial more than 18 years of either gender who are prescribed with HMG-CoA reductase
inhibitors.
Results
In the present study 200 patients belonged to the age group of above 18 years, out of which about 65% were male
and 35% were female. Atorvastatin (67%) was prescribed mostly and Rosuvastatin (29.5%) was also used.
Conclusion
It is finally concluded that Rational and prophylactic use of statins can reduce further complications of Diabetes
Mellitus (DM) and cardiac events.
Statins treatment is favourable in long term treatment of diseases, it is most effectively used in treatment of serious
disease conditions which has shown its immense therapeutic role in treatment
of study know the prevalence of burn in Hebron government hospitals to provide guidance for burn prevention, and to reduce
burns in Hebron and West Bank. Background Burns are a large cause of injury world. We discusses the epidemiology and result of burn patients in a big hospital and burn unite in south of west bank between 2016 and 2017 to provide directing for burn prevention
A Cross Sectional Study of Ethnic Differences in Occurrence and Severity of A...iosrphr_editor
Non-steroidal anti-inflammatory drugs are the most widely used "over the counter" medication all over the world despite their complications in different major organs. Present studies envisaged for knowing the occurrence and severity of adverse drug reactions from NSAIDs in different ethnic communities of Sikkim. A cross sectional study was undertaken in the medicine outpatients department of a secondary and tertiary care hospital. The patients belonging to Nepalese, Bhutias, Lepchas ethnic communities and others community (settlers from other parts of India) were included to analyzed the data based on the age and gender, ethnicity and ADRs, drugs and ADRs. Severity assessment was done using Hartwing and Siegel scale and causality assessment by Naranjo scale. Total 109 cases of ADRs, predominating in female were detected. Nepalese were the most affected and Gastrointestinal tract (GIT) being the most affected organ in them. Diclofenac showed maximum number of ADRs in all the communities. Maximum number of cases occurred on single day use (40.36%) of drugs. All the cases were belonging to the "possible category" and the maximum being the mild (72.48%) in nature. It is advisable to consider the ethnic/racial differences equally with other factors, to improve the safety and efficacy of a drug.
Household disposal of pharmaceuticals” a risk to the environment (A SURVEY)Gulzar Alam
The presence of pharmaceuticals are the nearly ubiquitous pollutants in both ground and surface waters environment, has become a cause for increasing concern in recent years. This study aimed to investigate the household disposal of unused and expired pharmaceuticals as a source of pharmaceuticals in the environment. The survey was carried out in major cities i.e. Ahemedabad, Gandhi Nagar, Amreli, Rajkot, and Vadodra of Gujarat state. We used the information on when and how they disposed of unfinished pharmaceuticals to construct a conceptual model to assess the pathways of pharmaceuticals into the environment. The model demonstrated that disposal of unused pharmaceuticals, either by household waste or via the sink or toilet, may be a prominent route that requires greater attention. This survey reveals important data regarding awareness, economics and other aspects regarding the use of household pharmaceuticals. So, overall conclusion of survey that the household disposal of pharmaceuticals among peoples in different place in Gujarat is very harmful for the environment and human health. Keywords: Pharmaceuticals, Pollutants, Household Disposal, Sink or Toilet
Association of CD4 T cell Recovery and Interpersonal Trust in Patient Physici...ijtsrd
The global HIV AIDS pandemic is still dangerous due to high incidence and high mortality rate. There are many factors associated with the immunological response beside treatment with medical practice. This paper aimed to assess the correlation of immunological responses and trust in physician measures in adult patients living with HIV AIDS. A cross sectional was studied to find the association between CD4 T cell changes and interpersonal trust in patient physician relationships. This study was carried out 93 aldult patients male accounted for 83.9 who were newly diagnosed with HIV AIDS infection at outpatient clinics, Tropical Diseases Hospital from October 2018 to August 2019. The mean TCD4 increased by 324.7 cells µl and 379.7 cells µl, respectively, compared to the original of 161.7 cells µl. Almost all patients had their immunity recovered after 3 and 6 months and the majority of patients have achieved virological success after 6 months of treatment. Factors associated with early immune recovery are youth, lower secondary education and single status. The majority of patients had truly trust in physician after 1 month and factors associated with trust in physician scale are male and employed. In Spearman rank correlation, CD4 T cell recovery and the trust present a strong relationship with p=0.008. Our finding is that the initial immunity recovery was strongly influenced by the interpersonal trust between the patients and the healthcare workers. Tao Gia Phu | Nguyen Hoang Lam | Cao Ngoc Nga | Vo Van Tam | Nguyen Phan Trong Hieu | Nguyen Van Trung "Association of CD4 T cell Recovery and Interpersonal Trust in Patient-Physician Relationship among HIV-Infected Adults in Hospital for Tropical Diseases, Vietnam" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30752.pdf Paper Url :https://www.ijtsrd.com/medicine/other/30752/association-of-cd4-t-cell-recovery-and-interpersonal-trust-in-patientphysician-relationship-among-hivinfected-adults-in-hospital-for-tropical-diseases-vietnam/tao-gia-phu
Molecular epidemiology is an emerging branch of epidemiology developed by merging molecular biology into epidemiological studies. Molecular epidemiology studies identify infectious diseases’ causation and pathogenesis and unravel infectious agents’ sources, reservoirs, circulation pattern, transmission pattern, transmission probability, and transmission order. Molecular epidemiology, an area of epidemiology that is somewhat ambiguous, encompasses utilization of biomarkers and genetics as tools to define both exposures (factors that are inherited) and outcomes (factors that are acquired). In last few decades, it has grown extensively to help to understand of disease ecology, in planning disease control, and in drafting health policies.
A study on prescription pattern and rational use of statins in tertiary care ...SriramNagarajan16
Objectives
Our objectives are to evaluate prescription pattern and rational use of statins in a tertiary care corporate hospital.
Methodology
It was a prospective observational study conducted for a period of 6 months and included various departments of 300
bedded multi specialty tertiary care corporate hospital. A total of 200 patients were included and the study criteria
was inpatients and induvial more than 18 years of either gender who are prescribed with HMG-CoA reductase
inhibitors.
Results
In the present study 200 patients belonged to the age group of above 18 years, out of which about 65% were male
and 35% were female. Atorvastatin (67%) was prescribed mostly and Rosuvastatin (29.5%) was also used.
Conclusion
It is finally concluded that Rational and prophylactic use of statins can reduce further complications of Diabetes
Mellitus (DM) and cardiac events.
Statins treatment is favourable in long term treatment of diseases, it is most effectively used in treatment of serious
disease conditions which has shown its immense therapeutic role in treatment
of study know the prevalence of burn in Hebron government hospitals to provide guidance for burn prevention, and to reduce
burns in Hebron and West Bank. Background Burns are a large cause of injury world. We discusses the epidemiology and result of burn patients in a big hospital and burn unite in south of west bank between 2016 and 2017 to provide directing for burn prevention
A Cross Sectional Study of Ethnic Differences in Occurrence and Severity of A...iosrphr_editor
Non-steroidal anti-inflammatory drugs are the most widely used "over the counter" medication all over the world despite their complications in different major organs. Present studies envisaged for knowing the occurrence and severity of adverse drug reactions from NSAIDs in different ethnic communities of Sikkim. A cross sectional study was undertaken in the medicine outpatients department of a secondary and tertiary care hospital. The patients belonging to Nepalese, Bhutias, Lepchas ethnic communities and others community (settlers from other parts of India) were included to analyzed the data based on the age and gender, ethnicity and ADRs, drugs and ADRs. Severity assessment was done using Hartwing and Siegel scale and causality assessment by Naranjo scale. Total 109 cases of ADRs, predominating in female were detected. Nepalese were the most affected and Gastrointestinal tract (GIT) being the most affected organ in them. Diclofenac showed maximum number of ADRs in all the communities. Maximum number of cases occurred on single day use (40.36%) of drugs. All the cases were belonging to the "possible category" and the maximum being the mild (72.48%) in nature. It is advisable to consider the ethnic/racial differences equally with other factors, to improve the safety and efficacy of a drug.
Epidemiology of Poisoning and Perception towards Poison Management Guidelin...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Past nonmedical opioid use could predict future heroin use among teensΔρ. Γιώργος K. Κασάπης
Two studies published yesterday point to predictors of teens using drugs. Researchers in one study found that teens who used opioids when they were not prescribed for medical reasons were more likely to later use heroin. Of the nearly 3,300 high schoolers who were included in the study, those who previously used opioids were about 11% more likely to use heroin, while those who currently used opioids were about 13% more likely to use heroin.
Another study found that there was no increase in teenagers using marijuana if they lived in a state that had laws legalizing the drug. In fact, in states with recreational marijuana laws, the odds of teen marijuana use were about 10% less following legalization.
Assessment of trend of mortality due to poisoning in the northern zone of india and comparison with other international & national researches
Authors:Naveen Sharma, Kunal Khanna, Kuldeep Kumar, Tarun Dagar, Sandeep Kumar Giri, Vijay Pal Khanagwal
Int J Biol Med Res. 2024; 15(1): 7741-7745
https://www.biomedscidirect.com/2824/assessment-of-trend-of-mortality-due-to-poisoning-in-the-northern-zone-of-india-and-comparison-with-other-international-national-researches
Self-Medication of Anti-Biotics amongst University Students of Islamabad: Pre...IOSR Journals
The prevalence and pattern of self-medication with antibiotics among undergraduate and graduate community of students at different universities of Islamabad was evaluated using structured self-medication administered questionnaire. This cross-sectional, study was conducted in March 2013. A convenience sample was taken from 4 non-medical universities of the city of Islamabad, Pakistan. Data was analyzed using SPSS v14 and associations were tested using the Chi square test. A total of 210 questionnaires were randomly distributed with a respondent rate of 100%. The prevalence of self-medication was found to be 77.03% (Female: Male Ratio=1:1.14). The major reasons given for self-medicating with antibiotics were; 33.63% assumed knowledge on antibiotics (P=0.478), 26.64% prior experience on use (P=0.378), while 9.17% admitted lack of time to go for consultation (P=0.130). Majority of respondents however, self-medicate with antibiotics occasionally. The most reported antibiotic class (48.58%) was the β-lactams (as amoxicillin) while co-trimoxazole was rarely used (2.23%). The most reported condition for self-medication was respiratory tract infections (59%). About almost half of the respondents (46.79%) purchased the drugs from drug stores. These findings highlight the needs for planning interventions to promote the judicious use of antibiotics within the student population
Poor Outcomes in a Cohort of HIV-Infected Adolescents Undergoing Treatment fo...Dr.Samsuddin Khan
Abstract
BACKGROUND:
Little is known about the treatment of multidrug-resistant tuberculosis (MDR-TB) in HIV-co-infected adolescents. This study aimed to present the intermediate outcomes of HIV-infected adolescents aged 10-19 years receiving second-line anti-TB treatment in a Médecins Sans Frontières (MSF) project in Mumbai, India.
METHODS:
A retrospective review of medical records of 11 adolescents enrolled between July 2007 and January 2013 was undertaken. Patients were initiated on either empirical or individualized second-line ambulatory anti-TB treatment under direct observation.
RESULTS:
The median age was 16 (IQR 14-18) years and 54% were female. Five (46%) adolescents had pulmonary TB (PTB), two (18%) extrapulmonary disease (EPTB) and four (36%) had both. Median CD4 count at the time of MDR-TB diagnosis was 162.7 cells/µl (IQR: 84.8-250.5). By January 2013, eight patients had final and 3 had interim outcomes. Favourable results were seen in four (36.5%) patients: one was cured and three were still on treatment with negative culture results. Seven patients (64%) had poor outcomes: four (36.5%) died and three (27%) defaulted. Three of the patients who died never started on antiretroviral and/or TB treatment and one died 16 days after treatment initiation. Two of the defaulted died soon after default. All patients (100%) on-treatment experienced adverse events (AEs): two required permanent discontinuation of the culprit drug and two were hospitalized due to AEs. No patient required permanent discontinuation of the entire second-line TB or antiretroviral regimens.
CONCLUSIONS:
Early mortality and mortality after default were the most common reasons for poor outcomes in this study. Early mortality suggests the need for rapid diagnosis and prompt treatment initiation, and adolescents might benefit from active contact-tracing and immediate referral. Default occurred at different times, suggesting the need for continuous, intensified and individualized psychosocial support for co-infected adolescents. Operational research among co-infected adolescents will be especially important in designing effective interventions for this vulnerable group.
The prevalence, patterns of usage and people's attitude towards complementary...home
The prevalence of CAM in Chatsworth is similar to findings in other parts of the
world. Although CAM was used to treat many different ailments, this practice could not be
attributed to any particular demographic profile. The majority of CAM users were satisfied with
the effects of CAM. Findings support a need for greater integration of allopathic medicine and
CAM, as well as improved communication between patients and caregivers regarding CAM usage.
A Study Regarding Knowledge of Anti Biotic Resistance among Engineering Stude...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Knowledge, Attitude and Practice of Self-Medication among Medical Studentsiosrjce
Self-medication is a common practice worldwide and the irrational use of the drugs is a major
cause of concern. Self-medication is an issue with serious global implication. The current study aimed to
determine the Knowledge, Attitude and Behavior of self-medication by medical students. A descriptive crosssectional
study was conducted among medical students currently studying first year to assess knowledge,
attitude and practice regarding self-medication in Chitwan Medical College, Bharatpur, Nepal. Seventy five
students studying in first year were selected for the study using stratified random sampling technique and data
was collected using a semi-structured self-administered questionnaire. The study finding revealed, the mean age
of 75 enrolled students was 20 years, 65.3% were in the age group of 17-20 years. Most of them were female
(72%). Seventy three point three percent belong to urban area. Prevalence rate of self-medication of one year
period seems high i.e. 84% and 68.25% in were females. The most common sources of information used by the
respondent were pharmacist (60.31%) and text book (46.03%). More than half of the respondent found to have
a good knowledge about self-medication regarding definition, adverse effect and different types of drug. The
attitude was positive towards self-medication and favored self-medication saying that it was acceptable. The
principal morbidities for seeking self-medication include cold and cough as reported by 85.7% followed by pain
76.2%, fever 73%, diarrhea 47.6% and dysmenorrheal 46%. Drugs / drugs group commonly used for selfmedication
included analgesics 75.8%, and anta-acids 53.2% and antipyretic 46.3%. Among reasons for
seeking self-medication, 79.2% felt that their illness was minor while 61.9% preferred as it is due to previous
experience. This study shows that self-medication is widely practiced among first year students of this medical
institution. There is dire need to make them aware about the pros and cons of self-medication in order to ensure
safe usage of drugs.
Drug use patterns among participants in a woman-focused RCT in GeorgiaIrma Kirtadze M.D.
The purpose of this poster presentation is to depict preliminary results from small-scale RCT IMEDI study and show the drug use patterns among women who use illicit substance and the rate of HIV infection.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
Introduction: Self‑ medication is commonly practiced all over the world. Self-medication is defined as the use
of medication by a patient on his own initiative or on the advice of a pharmacist or a lay person instead of
consulting a medical practitioner. The present study was aimed to estimate the prevalence of self-medication for
oral health problems among dental patients in Bengaluru city; to identify triggering factors that could influence
self-medication practices; to identify sources of medications used; to identify sources of information about
medications used; and to identify reasons for self-medication.Study Design: A Cross sectional Study.Methods:A
survey was conducted among 175 subjects among dental patients in Bengaluru city. Data were collected
through a specially designed proforma using a closed‑ ended, self‑ administered questionnaire containing 15
questions, in five sections.
Results: The prevalence of
Similar to The Epidemiology of Deliberate Self-Poisoning Presenting at a Tertiary Care Hospital in Hyderabad Sindh, Pakistan (20)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
The Epidemiology of Deliberate Self-Poisoning Presenting at a Tertiary Care Hospital in Hyderabad Sindh, Pakistan
1. ___________________________________________________________________________________________
*Corresponding author: Email: Faizanqaisar660@hotmail.com;
British Journal of Medicine & Medical Research
4(4): 1041-1048, 2014
SCIENCEDOMAIN international
www.sciencedomain.org
The Epidemiology of Deliberate Self-Poisoning
Presenting at a Tertiary Care Hospital in
Hyderabad Sindh, Pakistan
Faizan Qaisar1*
, Mohsin Shafi1
, Ayesha Majeed1
, Dileep Kumar1
,
Awais Memon1
and Umer Memon1
1
Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro,
Sindh, Pakistan.
Authors’ contributions
This work was carried out in collaboration between all authors. Author FQ designed the
study, wrote the protocol, and wrote the first draft of the manuscript. Author MS and DK
performed the statistical analysis, and ‘managed the analyses of the study. Authors AM, AM
and UM’ managed the literature searches and wrote the final draft. All authors read and
approved the final manuscript.
Received 15
th
August 2013
Accepted 9
th
October 2013
Published 4
th
November 2013
ABSTRACT
Objective: To observe the demographic characteristics of the patients, substance
abused, intention and precipitating factors for self-poisoning presenting to Accident&
Emergency department of Liaquat University Hospital Hyderabad, Sindh, Pakistan.
Patients and Methodology: A prospective observational study was carried out for a
period of 6 months from (March 2013 to August 2013).100 patients more than >12years
with a definite history of self-poisoning were included. Details regarding patients
demographic characteristics e.g. age, sex, maritalstatus, academic status,
socioeconomic standing etc. and substance abused for self-poisoning were recorded on
a specifically designed proforma.
Results: During the study period 100 patients of DSP were included. Of 100 patients
40% (n=40) were male age ranges from (15-50) and 60% (n=60) were female age
ranges from (17-50). Mean age of the patients was 23.63±8.370 (mean±SD). Out of
hundred patients 57% (F=31, M=26) were uneducated, 56% (F=34, M=22) were
unmarried, those who were unmarried had statistically significant relationship with the
Original Research Article
2. British Journal of Medicine & Medical Research, 4(4): 1041-1048, 2014
1042
use of organophosphorous compounds/Rat killer for self-poisoning (p= 0.0281). 85% of
the total patients belonged to lower socioeconomic class. Occupation wise mostly female
were household/house wife and male were farmer/labour. (49%) of the studied group
used organo-phosphorous containing compound insecticide/pesticides, 29% used Rat
killer. 11% of the patients consumed benzodiazepine for self-poisoning.60% of the total
patients had suicidal intention, use of organophosphorous compound/Rat killer is
significantly associated with the intention to suicide (p=0.0001), 33%of the patients
wanted to draw attention and 7% committed DSP to show anger, or to punish
themselves because of guilt Table 4. (46%) committed the act of DSP after having
conflict with parents other had interpersonal conflicts with husband/wife,
girlfriend/boyfriend and close relatives.
Conclusion: Use of organophosphorous containing compound/Rat killer are associated
with an intention to suicide (p=0.0001) and these are preferred substances used for self-
poisoning among unmarried population (p=0.0281).Demographic characteristics of
patients do not vary greatly with relation to their orientation to urban or rural areas as
well as choice of substance for self-poisoning were also independent to location
(p=1.0000).
Keywords: Self-poisoning; Liaquat university hospital Hyderabad; LUMHS Jamshoro;
Pakistan.
1. INTRODUCTION
Deliberate self-harm can be defined as an act in which a person harms himself/herself or
willfully ingest excessive or lethal dose of a drug which usually results in a non-fatal
outcome. European suicidology use the term of ‘Parasuicide’ for all such non-fatal suicidal
attempts [1].Deliberate self-poisoning (DSP) is an important health issue worldwide
especially in developing countries [2-3]. Exact prevalence of deliberate self-poisoning (DSP)
in Pakistan is not known as many of the cases of self-poisoning are not reported due to
religious, cultural, social reasons. However, available data on suicide suggests that in
Pakistan about 8 per 100,000 commit an act of deliberate self-poisoning per year [3].DSP is
not always associated with an intention to commit suicide as in some cultures, it is a
preferred and effective way to express anger, jealousy, and hostility or draw attention [4-
7].Nature and causes of deliberate self-poisoning are influenced by many factors such as
religion, socioeconomic status, ethnic background, and culture [8]. DSP increase morbidity
and mortality. Furthermore, the cost of managing DSP is also considerable especially in a
developing country like Pakistan[9-10].Para suicide is an important predictor of suicide in an
individual therefore several studies have been conducted on this issue all over the world as
well as in many cities of Pakistan. However, most of them are retrospective and were
performed in urban areas of Pakistan [11-12].We aimed to perform a prospective
observational study to report our experience of managing DSP patients at accident and
emergency unit of LUH Hyderabad, Sindh, Pakistan.
2. MATERIALS AND METHODS
Liquate University Hospital is a tertiary care teaching hospital. It is situated in Hyderabad,
the 2nd largest city of Sindh, Pakistan. Its accident &emergency unit works 24 hours a day
and deals with all sort of medical emergencies together with the cases of poisoning from
main Hyderabad city, villages close to Hyderabad and rural areas of interior Sindh. We
3. British Journal of Medicine & Medical Research, 4(4): 1041-1048, 2014
1043
performed cross-sectional, observational study from March 2013 to August 2013and
included all the patients more than 12 years old with a definite history of deliberate self-
poisoning .Cases of homicidal or accidental poisoning were excluded.DSP was defined as
ingestion of a poison or excessive dose of a medicine for self-harm. An Informed consent
was taken from each patient or from the accompanying attendant/close relative/guardian if
patient was unconscious. Participants who were less than <20 years an informed consent
was taken from their parents. Patient demographic details like age, gender, occupation,
address, socioeconomic status, marital standing, academic level, history of previous
attempts, poison used, and intention for self-harm were collected on a specifically designed
proforma. Areas that have the designation of, municipal committees, municipal corporations
or cantonment boards were considered urban areas and all the rest as rural. On the basis of
occupation, place of residence and monthly income socioeconomic status was determined
and classified as lower class, middle class and upper class. Educational status was
categorized into; uneducated, primary, Secondary, Intermediate or graduate and Masters.
2.1 Statistical Analysis
SPSS version 17 was used to analyze all the data collected and extracted in this study.
Categorical variable were expressed as percentage and continuous data were expressed as
mean +- SD. In addition the association and correlation between two categorical variables
were examined using the chi square test & fisher exact. A p-value of <0.05 was considered
statistically significant.
3. RESULTS
During the study period 100 patients of DSP were included. Of 100 patients 40% (n=40)
were male age ranges from (15-50) and 60%(n=60) were female age ranges from (17-50).
Mean age of the patients was 23.63±8.370 (mean±SD) Table 1.Out of hundred patients
57%(F=31, M=26) were uneducated, 56%(F=34, M=22) were unmarried. Use of
organophosphorous compounds/Rat killer for self-poisoning has a statistically significant
relationship with the unmarried population (p= 0.0281) Table 5. 85% of the total patients
belonged to lower socioeconomic class. Occupation wise mostly female were
household/house wife and male were farmer/labour. Complete detail of patient’s
demographic characteristics is summarized in Table 2. (49%) of the studied group used
organo-phosphorous containing compound insecticide/pesticides, 29% used Rat killer, 11%
of the patients consumed benzodiazepine for self-poisoning. Detail regarding other
substances used in our study for DSP is given in Table 3.60% of the total patients had
suicidal intention, use of organophosphorous compound/Rat killer is significantly associated
with the intention to suicide (p=0.0001) Table 5, 33%of the patients wanted to draw attention
and 7% committed DSP to show anger, or to punish themselves because of guilt Table 4.
(46%) committed the act of DSP after having conflict with parents other had interpersonal
conflicts with husband/wife, girlfriend/boyfriend and close relatives Table 5.Whereas 2% of
the patients committed DSP because of unemployment. Of 100 patients only 2% (n=2) had a
history of previous attempt of DSP.
4. British Journal of Medicine & Medical Research, 4(4): 1041-1048, 2014
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Table 1. Age distribution
Age Male Female
15-25
26-35
36-45
>45
Total
25
11
04
00
40
48
06
04
02
60
Table 2. Demographic details of patients
Education F
N=60
M
N=40
%
Primary 09 10 19 %
Secondary 3 4 7%
Matric 8 7 15%
Intermediate 2 0 2%
Uneducated 31 26 57%
Socioeconomic Status
Middle Class 08 07 15%
Lower Class 52 33 85%
Marital Status
Single 34 22 56%
Married 24 18 42%
Divorce 02 0 2%
Occupation
House Wife 18 0 18%
Household 34 0 34%
Students 08 7 15%
Labour 0 15 15%
Farmer 0 18 18%
Table 3. Substance/compound
Substance used Female
n=60
Male
n=40
%
Organophosphorous 26 19 45%
Rat Killer 15 14 29%
Sleeping Pills 06 5 11%
Vinegar 0 02 2%
Phenyl 6 00 6%
Ibert Folic 03 00 3%
Mosquito Killer 04 00 4%
5. British Journal of Medicine & Medical Research, 4(4): 1041-1048, 2014
1045
Table 4. Intention
Intention F
N=60
M
N=40
%
Suicide 38 22 60%
Draw Attention 16 16 32%
Self-Punishment 06 02 8%
Table 5. Precipitating factor
Precipitating factor Female
n= 60
Male
n= 40
%
Conflict With Parents 19 27 46%
Conflict With Relative 9 0 9%
Conflict With Children 04 02 6%
Conflict With Inlaws 09 0 9%
Conflict With Wife 0 02 2%
Conflict With Brother 4 02 6%
Conflict With Husband 11 11%
Conflict With Boyfriend/Girl Friend 4 05 9%
Unemployment 0 02 2%
Table 6. Chi-square with Yates correction
Association p-value =<0.05
Gender * choice of substance 0.5997
Socioeconomic status* choice of substance 0.7100
Location *choice of substance 1.0000
Marital status*choice of substance 0.0281
Education *choice of substance 0.9842
Intention*choice of substance 0.0001
Gender*intention 0.1572
Socioeconomic status*intention 0.9039
Location *intention 0.8583
Marital status*intention 0.8810
Education *intention 0.9039
4. DISCUSSION
LUH Hyderabad entertains all kind of emergencies including all cases of poisoning not only
from main city of Hyderabad but also from its surrounding villages and remote rural areas of
interior Sindh. In our study 56% patients belong to urban area of Hyderabad city and 44%
were from rural areas of interior Sindh Pakistan and villages close to Hyderabad.
Major findings of our study were a mixed population of the DSP Patients, 56% of them
belonged to main Hyderabad city and 44% of the patients were inhabitants of the villages
close to Hyderabad or remote areas of interior Sindh.Proportion of the female was greater
than male(60%).Mean age of the patients was 23.63±8.370 (mean±SD) Table 1. Out of
hundred patients 57% (F=31, M=26) were uneducated, 56% (F=34, M=22) were unmarried.
85% of the total patients belonged to lower socioeconomic class. (45%)(F=26, M=19) used
6. British Journal of Medicine & Medical Research, 4(4): 1041-1048, 2014
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organ phosphorous compound followed by Rat killer 29% (F=15, M 14). 80% (F=38, M=22)
patients had suicidal intention.
In terms of patients demographics our study agrees with the studies conducted in other cities
of Pakistan with slight variations. Study from a tertiary care hospital of Karachi reported that
they found female (59%) outnumbered the male (41%) with the age ranges from 12-
76.married women 32% were more than single women 25% while married men were 16%
and the number of divorces and widowed were negligible [13].Another study which was
carried out in JPMC Karachi reported that in their study 57% were female and 43% were
male with mean age 20 + 5years.47% were unmarried,48% were married while many of
them belong to Lower social economic class [14].Furthermore, a study that was carried out
in the accident and emergency department of Lahore reported that majority of patient were
female 60% self-poisoning found to be more in married women. Lower social class is
predominate [3].Study from a medical college in Quetta reported that in their study all of the
patients were female, most of them were young 16-25 years and belonged to lower social
class [15].
In our study, Organ phosphorous containing compound pesticide/insecticide (45%) and Rat
killer (11%) were found to be dominant agents used for self –poisoning (p=0.0281). Studies
that were conducted within the urban areas of Pakistan reported the use of other agents as
to be the most commonly used agents. A study in a tertiary care hospital in Karachi reported
that 47.3% used benzodiazepine for self- poisoning [16]. Another study from the same
hospital found use of benzodiazepine 60%, followed by organophosphate /insecticide
ingestion 20% to be most common agents for self-poisoning [13]. A study conducted in
Lahore reported use of benzodiazepine pills the predominantly consumed substance
28.57%followed by wheat pills (21.42%), copper sulphate (11.3%) and organophophate
compound (5.72%) [3]. Another study from the same hospital reported the ingestion of wheat
pills the most common mode of self -poisoning (33%) followed by bleach/bathroom cleaner
(25.7%), benzodiazepine (19%) [14].However in our study we found no significant
relationship among urban or rural population in relation to their choice of substance for self-
poisoning (p=1.0000).This may reflect the people included in our study, as several of them
were inhabitants of villages close to Hyderabad and rural areas of interior Sindh. Use of O.P
compounds and rat killer is common in villages and rural Sindh. Although 56% of patients in
our study belonged to urban area of Hyderabad, however, a good many number of people
living in Hyderabad have been migrated to Hyderabad from interior Sindh recently.
In our study we found conflict with parents (46%) and conflict with husband (11%) to be the
predominant precipitating factors for self- poisoning. Whereas a study conducted in
university hospital Karachi found interpersonal conflicts with the opposite sex to be the most
common precipitating factors. [10].Domestic problems and financial difficulties were reported
to be common factors for self-poisoning in the study conducted in Jinnah hospital Lahore [3].
In our study we found that 60% of patient had an intention to suicide .In a study conducted
by M.M Khan and H. Raza suicidal intention in 70%of patients were reported [16].we found
a statistical significant relationship between organophosphrous compounds/Rat killer and
intention to suicide (p=0.0001).
4.1 Limitation
Our study only addresses demographic character of the patients committing self-poisoning
and the substance used by them. It does not address the reason why patients belonging to
7. British Journal of Medicine & Medical Research, 4(4): 1041-1048, 2014
1047
lower socioeconomic group and uneducated are more vulnerable to self-poisoning. This
study also does not give details regarding the psychiatric morbidities, management plan of
these patients and resulting morbidity and mortality. These objectives were not within the
scope of our study. Although in the rural areas of Sindh use of organophosphorous
pesticides is common round the year but seasonal variability cannot be ignored this is why 6
months period may be insufficient for the exact evaluation of poison epidemiology.
5. CONCLUSION
The study shows thatuse of organophosphorous containing compound/Rat killer are
associated with an intention to suicide (p=0.0001) and these are preferred substances used
for self-poisoning among unmarried population.(p=0.0281).Although tendency to self-
poisoning in our study is more common among (socioeconomic class, uneducated people
and young age group with the preponderance of female but all these factors are independent
to each other, no statistically significant relationships were found Table 5. Demographic
characteristics of patients do not vary greatly with relation to their orientation to urban or
rural areas as well as choice of substance for self-poisoning were also independent to
location.
Easy availability of organ-phosphorous containing pesticides and rat killer as well as selling
of benzodiazepines compound in the form of sleeping pills and anxiolytics without
prescription have increased the risk of self-poisoning. Appropriate measures against the
selling of these compounds may decrease the incidence of self-poisoning.
CONSENT
All authors declare that ‘informed consent was obtained from the patient or accompanying
attendants.
ETHICAL APPROVAL
Not applicable.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
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