scholarly journals Standards of Lithium Treatment Monitoring In a Teaching Hospital in South India among Bipolar Affective Disorder

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Dr. Sureshkumar Ramasamy ◽  
Dr. Shilpa Srinivasan ◽  
Dr. Shree Aarthi Ramanathan
Keyword(s):  
Serum Creatinine ◽  
Affective Disorder ◽  
Lithium Treatment ◽  
Bipolar Affective Disorder ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Care Hospital ◽  
Retrospective Audit ◽  
Bipolar Patients

Background: Lithium is a commonly used drug with a narrow therapeutic index, it has significant adverse effects on kidney and thyroid, and is life threatening during intoxication. Maudsley guidelines on managing bipolar affective disorder patients (BPAD) with lithium recommends checking weight at baseline and every 3rd month, serum lithium after 7th day thereafter 3 months once, renal function test and serum thyroid stimulating hormone (TSH) at baseline and 6 months once. Aim: To evaluate whether Pre-Lithium workup and monitoring is done in Bipolar affective disorder (BPAD) patients initiated on Lithium as per Maudsley prescribing guidelines in psychiatry. Method: Retrospective audit conducted in a tertiary care hospital on lithium monitoring in BPAD patients treated with lithium atleast for six months compared against Maudsley prescribing guidelines. Results: Among medical records of 114 bipolar patients fulfilling study criteria, weight and serum lithium at baseline was checked in 100% of patients; serum creatinine and TSH at baseline along with lithium at 3rd month was done in 83.3%, 78.9% and 68.4% of patients respectively. Maudsley guidelines for serum creatinine, TSH and lithium level at 6th month were met only in 43.8%, 43.8% and 72.8% of patients respectively. Conclusion: The quality of lithium monitoring in bipolar patients falls well short of accepted standards; Hence addressing the issues in monitoring and following a standard protocol can improve the effectiveness of treatment and quality of life of patients.

scholarly journals Quality of Life in Schizophrenia and Bipolar Affective Disorder

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Pratima
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Affective Disorder ◽  
Expressed Emotion ◽  
Bipolar Affective Disorder ◽  
Poor Quality ◽  
Living Environment ◽  
The Family ◽  
Bipolar Patients

Family caregivers of persons with bipolar disorder and schizophrenia experience high level of burden and compromised quality of life. A considerable amount of burden on the caregivers often leads to display of certain attitudes towards persons with severe mental illness called expressed emotion, which then leads to poor quality of patients as well. Although numerous studies dealing with these issues separately are present, but studies dealing with relationship, using mixed methodology, among these issues are scarce. The aim of the present study was to understand how actually the construct of quality of life in different demographic conditions affect life conditions of schizophrenic and bipolar patients and determining relapse. The present study was designed mainly to assess the quality of life on patients and the families of a particular group of patients namely those with schizophrenia and bipolar disorder. The objectives if the present research were to study: (i) the quality of life of patients with Schizophrenia and Bipolar Affective disorder. (ii) the quality of life of caregivers of patients with Schizophrenia and Bipolar Affective disorder. Patients with disorders such as schizophrenia and bipolar affective disorder are more likely to relapse when there is high expressed emotion present in their living environment. The stress from the remarks and attitudes of the family is overwhelming because they feel like the cause of the problems. The patient then falls into the cycle of relapse. The only way to escape this vortex for the family is to go through therapy together to prevent the relapse. But before that it becomes necessary to understand that what is the reason behind such attitude towards a family member who is mentally ill, what is the cause of burden and what all changes the caregivers’ and the patients’ quality of life come across.

scholarly journals Efficacy of Sodium Valproate and Olanzapine in treating bipolar affective disorder 'mania' at a tertiary care hospital in Nepal: A comparative study

2017 ◽  
Vol 4 (1) ◽  
pp. 27-35
Author(s):  
Lokeshwar Chaurasia ◽  
Sunil Kumar Shah ◽  
Sudarshana Magham Chetty
Keyword(s):  
Affective Disorder ◽  
Sodium Valproate ◽  
Rating Scale ◽  
Tertiary Care Hospital ◽  
Bipolar Affective Disorder ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Sciences ◽  
Significant Difference ◽  
The Mean

Background and Objectives: Bipolar affective disorder, mania is the mood of an abnormally elevated arousal energy level or a state of heightened overall activation with enhanced affective expression together with lability of affect. The objective of the study was to compare the efficacy of sodium valproate and olanzapine in bipolar affective disorder, mania patients at a tertiary care hospital in NepalMaterial and Methods: A randomized observational prospective open label study was conducted for one and half year at College of Medical Sciences-Teaching Hospital (CMS-TH), Bharatpur, Nepal in the Psychiatry Department. Sixty patients diagnosed with bipolar affective disorder, mania were enrolled. 30 patients received sodium valproate and 30 patients received olanzapine. Patients were monitored and evaluated on baseline (day 0), day 7 and day 30 and compared to the baseline for the severity of illness using the 11-item Young Mania Rating Scale (YMRS).Results: The mean baseline YMRS score for all cases on sodium valproate (n=30) on day 0 was 38.87 ± 3.73, while it was reduced to 13.90 ± 1.95 (p < 0.001) on day 30. Similarly, the mean baseline YMRS score for all cases on olanzapine (n=30) on day 0was 40.83 ± 6.50, while it was reduced to 14.47 ± 2.83 (p < 0.001) on day 30.The mean decrease in YMRS score by sodium valproate was 64.24% and by olanzapine was 64.56%.Conclusion: Treatment with sodium valproate and olanzapine significantly improves the mean mania ratings score and there is no statistically significant difference in efficacy of both the drugs in patients diagnosed with bipolar affective disorder, mania.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4(1): 27-35

scholarly journals A 2 year histopathological audit for non-oncological hysterectomies in a tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 3260
Author(s):  
Salma Bhat ◽  
Nazia Bhat ◽  
Isma Niyaz ◽  
Rohi Wani
Keyword(s):  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Definitive Treatment ◽  
Care Hospital ◽  
Gynecological Surgery ◽  
Surgical Indications ◽  
Dysfunctional Uterine Bleeding ◽  
Retrospective Audit

Background: Hysterectomy is the most common gynecological surgery in the world and is considered to be the most definitive treatment option for various diseases like DUB (dysfunctional uterine bleeding), leiomyoma, adenomyosis, chronic pelvic pain, prolapse, and malignancy. The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimensMethods: This was a retrospective audit. The pre-operative diagnosis and histopathologic data of all consecutive specimens of hysterectomies were collected and analysed. Those with confirmed malignancy before operation were excluded. All elective as well as emergency hysterectomies (including obstetric hysterectomies) were analyzed. Preoperative indications were compared with the final histopathological report.Results: Most common indication for hysterectomy was symptomatic fibroid uterus followed by utero-vaginal prolapse and obstetric causes. Overall, there was no pathology identified in approximately 50% of all hysterectomies received in our department.Conclusions: Proper audit and review can help in improving the quality of health care in our country. The results of our study may help to reduce inappropriate indications for hysterectomy.

Antinuclear autoantibodies in relation to bipolar affective disorder and lithium therapy

1996 ◽  
Vol 11 (1) ◽  
pp. 50-52 ◽  
Author(s):  
B Spivak ◽  
M Radwan ◽  
P Bartur ◽  
R Mester ◽  
A Weizman
Keyword(s):  
Affective Disorder ◽  
Antinuclear Antibodies ◽  
Lithium Treatment ◽  
Bipolar Affective Disorder ◽  
Lithium Therapy ◽  
Healthy Controls ◽  
Antinuclear Autoantibodies ◽  
Dna Antibodies ◽  
Bipolar Patients ◽  
Drug Free

SummaryWe investigated the presence of antinuclear antibodies (ANA) in 63 drug free and lithium treated bipolar patients as compared to 37 healthy controls. Increased frequency of positive ANA was detected in bipolar patients in comparison to controls (19% vs 5%, respectively, P < 0.05). This finding was unrelated to lithium treatment. No antinative DNA antibodies or antihistone reactive antibodies were detected among the ANA positive subjects.

Assessment of Quality of Life (QoL) in Systemic Lupus Erythematosus Patients at a Tertiary Care Hospital in Egypt

2019 ◽  
Vol 15 (4) ◽  
pp. 304-311
Author(s):  
Mervat E. Behiry ◽  
Sahar A. Ahmed ◽  
Eman H. Elsebaie
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Tertiary Care ◽  
Damage Index ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Systemic Lupus

: Systemic Lupus Erythematosus (SLE) has a profound impact on quality of life. Objective: The objective of this study was to explore the quality of life among Egyptian SLE patients and to assess its relationships with demographic and clinical features. Methods: One hundred sixty-four SLE patients were recruited for this study. Demographic information; clinical parameters; disease activity, as evaluated by the systemic lupus erythematosus Disease Activity Index; and organ damage, as assessed by the systemic lupus international Collaborative Clinics/American College of Rheumatology Damage Index, were reported. Quality of life was assessed with a quality of life questionnaire specifically designed for patients with systemic lupus erythematosus; the questions are grouped in the following six domains: physical function, sociooccupational activities, symptoms, treatment, mood, and self-image. Higher values indicate poorer quality of life. Conclusion: Poor quality of life among Egyptian SLE patients and disease activity are strongly related to impaired lifestyles in these patients.

scholarly journals The effect of care transition pathway implementation on patients undergoing joint replacement during the COVID-19 pandemic: a quasi-experimental study from a tertiary care hospital orthopedic department in Beijing, China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ya-ping Xu ◽  
Pei-yu Zhao ◽  
Yi-tong Bai ◽  
Shuang Li
Keyword(s):  
Joint Replacement ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Transition ◽  
Control Group ◽  
Care Hospital ◽  
Quasi Experimental ◽  
And Control ◽  
Beijing China

Abstract Background The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. Methods A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. Results The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. Conclusions A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.

Frequency of factors leading to acute renal failure in obstetric patients.

2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Placental Abruption ◽  
Post Partum ◽  
Common Factor ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.

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