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Profile and in-hospital outcomes of deliberate self-harmed patients in a tertiary care centre 三级保健中心蓄意自残病人的概况和住院结果
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_33_22
J. John, K. Rashmi, R. Jayachandran
Objective: Suicide is an unrecognised and underestimated epidemic of high complexity and accounts for premature loss of at least 1 million lives worldwide, leaving behind irreparable loss and backlash to family, friends and society. This study was carried out with the aim of analysing the clinical presentation, modes of deliberate self-harm (DSH), demographic and biochemical features with outcomes of patients presenting with DSH and admitted through the emergency unit of the medicine department to a tertiary care teaching hospital in South India. Materials and Methods: The clinical presentation, demographic details, psychiatric evaluation and blood investigations of patients admitted with a history of DSH during the study (2020–2021) were analysed, with special emphasis on serum cholesterol, C-reactive protein (CRP) and thyroid-stimulating hormone (TSH). Results: In this study, of the 508 patients studied, the most common mode of self-harm was poisoning by drug overdose (32.28%) followed by plant toxin poisoning and rodenticide ingestion-finding different from other studies of South India during this COVID pandemic. Values of TSH, serum cholesterol, CRP and haematogram were normal in majority of patients. All the patients underwent psychiatry evaluation in which substance abuse, adjustment disorders and personality disorders were the most common diagnosis reached. Conclusions: Clinical profile and methods of DSH have marked regional variation necessitating the need to create a regional database. Serum cholesterol, CRP and TSH are subject to genotypic and regional variations and thus are not reliable as biomarkers of suicidal ideation.
目的:自杀是一种未被认识和低估的高度复杂流行病,在世界范围内造成至少100万人过早死亡,给家庭、朋友和社会造成无法弥补的损失和强烈反应。本研究的目的是分析临床表现、故意自残(DSH)模式、人口统计学和生物化学特征与结果,这些患者是通过印度南部一家三级护理教学医院内科急诊科收治的。材料与方法:分析研究期间(2020-2021年)有DSH病史患者的临床表现、人口统计学细节、精神病学评估和血液调查,重点分析血清胆固醇、c反应蛋白(CRP)和促甲状腺激素(TSH)。结果:在本研究中,508例患者中,最常见的自残方式是药物过量中毒(32.28%),其次是植物毒素中毒和误食灭鼠剂,这与南印度其他研究在本次COVID大流行期间的发现不同。多数患者TSH、血清胆固醇、CRP及血图均正常。所有患者都接受了精神病学评估,其中药物滥用、适应障碍和人格障碍是最常见的诊断。结论:DSH的临床概况和方法有明显的区域差异,需要建立一个区域数据库。血清胆固醇、CRP和TSH受基因型和区域差异的影响,因此作为自杀意念的生物标志物不可靠。
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引用次数: 0
Pharmacovigilance study of spontaneous adverse drug reaction in a tertiary care centre 某三级保健中心自发性药物不良反应的药物警戒研究
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_7_22
Wazid Ali, Smita Manjavkar, Imran Kazmi, Shamim Khan
Background: Adverse drug reactions (ADRs) are a rapidly growing universal problem that has a significant impact on users worldwide. They are the cause of significant disability and mortality and are expected to be associated with an economic burden on the health-care system. Aims: To promote patient safety from pharmaceutical products. Materials and Methods: A prospective, observational evaluation of the ADRs collected during spontaneous pharmacovigilance reporting over a period of 18 months in various hospital departments. During the study period, 214 individual case safety reports (ICSR) were reported. Results: The 214 reports that were identified, a slightly higher percentage of ADRs in females 105 (50.93%) was observed as compared to males 109 (49.07%), 73 (34.1%) serious and 141 (65.9%) non serious ADRs. In serious ADRs, the male patients were 35 (33.3%) and females were 38 (34.9%) including 6 (2.8%) deaths. The largest number of reports was associated with antimicrobials 41% followed by non-steroidal anti-inflammatory drugs − 21.1%, antidiabetic − 10.9%. The most commonly implicated organ system was skin − 46.62% followed by gastrointestinal reactions − 18.05%, blood and metabolic disorder − 11.65%, central nervous system − 6.77%, liver − 6.02% and cardiovascular system (3.38%). The outcomes were recorded as recovering (45.8%), recovered (26.2%), continuing (19.2%) and unknown (6.1%) at the time of processing ICSR through vigiflow database. The causality of more than half of ADRs were recorded as possible (59.8%) followed by probable (24.8%), certain (15%) and unlikely (0.5%). Conclusion: Limited ADR is permissible in normal clinical trials setting; hence, spontaneous adverse reaction reporting systems need to be developed, which may improve rational drug prescribing habits to obtain maximum benefits meanwhile minimizing the risk of health from undesirable effects of drugs.
背景:药物不良反应(adr)是一个迅速增长的普遍问题,对全世界的使用者产生了重大影响。它们是造成严重残疾和死亡的原因,预计会给卫生保健系统带来经济负担。目的:促进患者对药品的安全。材料和方法:对18个月来各医院部门自发药物警戒报告中收集的不良反应进行前瞻性观察性评估。在研究期间,报告了214例个案安全报告(ICSR)。结果:214例adr报告中,女性105例(50.93%)高于男性109例(49.07%),严重adr 73例(34.1%),非严重adr 141例(65.9%)。严重不良反应中,男性35例(33.3%),女性38例(34.9%),死亡6例(2.8%)。报告数量最多的是抗菌素(41%),其次是非甾体抗炎药(21.1%)和降糖药(10.9%)。最常涉及的器官系统为皮肤(46.62%),其次是胃肠道反应(18.05%)、血液和代谢紊乱(11.65%)、中枢神经系统(6.77%)、肝脏(6.02%)和心血管系统(3.38%)。在vigiflow数据库处理ICSR时,结果记录为恢复(45.8%)、恢复(26.2%)、持续(19.2%)和未知(6.1%)。超过半数adr的因果关系为可能(59.8%),其次为可能(24.8%)、确定(15%)和不可能(0.5%)。结论:在正常的临床试验环境下,有限的不良反应是允许的;因此,需要建立自发的不良反应报告系统,以改善合理的用药习惯,获得最大的利益,同时最大限度地减少药物不良反应对健康的风险。
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引用次数: 0
Synchronous primary malignancies and pre-cancers affecting entire hysterectomy specimen: A report of an unfortunate case 同时原发恶性肿瘤和癌前病变影响全子宫切除标本:一个不幸的病例报告
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_94_21
S. Bharti, Iffat Jamal, Pritanjali Singh
Synchronous tumours of the female genital tract are rare, accounting for approximately 1%–2% of all gynaecological malignancies involving simultaneous independent primary malignancies. Synchronous tumours in the ovary and endometrium are the most common combination. We report on a 58-year-old postmenopausal woman who presented with bleeding per vaginum for 1.5 months with no prior menstrual complaints. On per vaginal examination, a mass was felt in the pelvis. Ultrasonography revealed a mass of 8 cm × 9 cm in size filling the entire uterine cavity. Contrast enhanced computed tomography showed a multilobate mass in the pelvis, replacing the whole uterus and cervix, with heterogeneous enhancement and internal necrosis. Bilateral ovaries were not visualised separately. The radiological impression suggested an endometrial carcinoma. Wertheim's hysterectomy was subsequently performed. On microscopic examination, the uterine mass revealed a malignant mixed Müllerian tumour (carcinosarcoma) of the endometrium, along with a high-grade serous carcinoma of the left ovary and left fallopian tube. The right fallopian tube showed adenocarcinoma in situ. The patient had an unusual past history of multiple system comorbidities, a few of which were continuing and for which she was receiving medical treatment.
女性生殖道的同步肿瘤是罕见的,约占所有妇科恶性肿瘤同时独立原发恶性肿瘤的1%-2%。卵巢和子宫内膜的同步肿瘤是最常见的组合。我们报告一个58岁的绝经后妇女谁提出每个阴道出血1.5个月,以前没有月经投诉。阴道检查发现骨盆有肿块。超声检查显示一个8厘米× 9厘米大小的肿块充满了整个子宫腔。增强计算机断层扫描显示骨盆多叶状肿块,取代了整个子宫和子宫颈,伴有不均匀强化和内部坏死。双侧卵巢未单独显像。影像学表现提示子宫内膜癌。随后进行了韦特海姆子宫切除术。镜下检查,子宫肿块显示子宫内膜恶性混合性勒氏瘤(癌肉瘤),同时伴有左侧卵巢和左侧输卵管的高级别浆液性癌。右输卵管显示原位腺癌。患者有不同寻常的多系统合并症病史,其中一些仍在继续,她正在接受治疗。
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引用次数: 1
Do checklist-based box system interventions improve post-natal care service utilisation? 基于检查清单的盒子系统干预措施是否改善了产后护理服务的利用?
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_38_22
M. Taywade, Debkumar Pal, D. Sahu
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引用次数: 0
Challenges in Medical Education - Let's talk about solutions 医学教育的挑战——让我们谈谈解决办法
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_39_22
H. Gupta
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引用次数: 0
SARS-CoV-2 infection evolving into aplastic anaemia: An unusual presentation of COVID-19 in the paediatric age group SARS-CoV-2感染演变为再生障碍性贫血:儿童年龄组中不寻常的COVID-19表现
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_55_21
Akanksha Bhatia, Vijay Kumar, A. Yadav
Aplastic anaemia can develop due to various viral infections. However, SARS-CoV-2 infection evolving into aplastic anaemia is rarely seen. Here, we present a case of a 6-year-old boy who presented with epistaxis and rashes all over the body after recovery from COVID-19. Peripheral blood smear examination revealed pancytopenia with neutropenia and also reticulocytopenia. Bone marrow biopsy showed a hypoplastic marrow (cellularity of 10%), leading to a diagnosis of aplastic anaemia.
再生障碍性贫血可由各种病毒感染引起。然而,SARS-CoV-2感染演变为再生障碍性贫血的情况很少见。在这里,我们报告了一个6岁男孩的病例,他在COVID-19康复后出现了鼻出血和全身皮疹。外周血涂片检查显示全血细胞减少症合并中性粒细胞减少症和网状细胞减少症。骨髓活检显示骨髓发育不良(细胞量10%),诊断为再生障碍性贫血。
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引用次数: 0
To study the role of magnesium and Gamma- glutamyl transferases in alcoholic liver disease 目的:探讨镁和γ -谷氨酰转移酶在酒精性肝病中的作用
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_63_21
K. Gaikwad, S. Selkar, S. Agrawal
Aim: To study the role of magnesium and gamma- glutamyl transferases in alcoholic liver disease. Objectives: (1) To estimate serum magnesium and serum glutamyl-transferases (GGT) in alcoholic liver disease. (2) To estimate liver enzymes Alanine Transaminases (ALT), Aspartate Transaminases (AST), Alkaline Phosphatase (ALP), and Total protein and Albumin in alcoholic liver disease. (3) To correlate serum magnesium with all liver enzymes. (4) To correlate serum GGT with all liver enzymes. Materials and Methods: All liver enzymes, serum magnesium, serum GGT, total protein and albumin were estimated in 50 alcoholic liver disease patients and 50 normal subjects on Trivitron Dirui autoanalyzer. Results: Significant difference was found between mean values of cases and controls in Mg, GGT, AST, ALT, Alkaline phosphatase, and Albumin (P<0.05). Positive correlation was found between Mg with GGT, ALT, Total proteins and Albumin. This indicates that the higher(lower) values of Mg are associated with higher(lower) values of GGT, ALT, Total proteins, and Albumin. But the result were not statistically significant.(P >0.05). Conclusion: Chronic alcoholic liver disease significantly elevates Gamma-glutamyl transferase. Hypomagnesemia is also seen in alcoholic liver disease. Gamma-glutamyltransferase has a significant relation with magnesium levels in alcoholic liver disease.
目的:探讨镁和γ -谷氨酰转移酶在酒精性肝病中的作用。目的:(1)测定酒精性肝病患者血清镁和谷氨酰转移酶(GGT)水平。(2)评估酒精性肝病的肝酶:丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、总蛋白和白蛋白。(3)血清镁与所有肝酶的相关性。(4)血清GGT与所有肝酶的相关性。材料与方法:用Trivitron Dirui自动分析仪测定50例酒精性肝病患者和50例正常人的所有肝酶、血清镁、血清GGT、总蛋白和白蛋白。结果:Mg、GGT、AST、ALT、碱性磷酸酶、白蛋白平均值与对照组比较,差异有统计学意义(P0.05)。结论:慢性酒精性肝病显著升高γ -谷氨酰转移酶。低镁血症也见于酒精性肝病。酒精性肝病患者γ -谷氨酰转移酶与镁水平有显著关系。
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引用次数: 1
Understanding suicide: A biopsychosocial framework 理解自杀:一个生物心理社会框架
Pub Date : 2022-05-01 DOI: 10.4103/cmrp.cmrp_48_22
Soumya Tandon
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引用次数: 1
Need for COVID-19 vaccination in children 儿童COVID-19疫苗接种的必要性
Pub Date : 2022-03-01 DOI: 10.4103/cmrp.cmrp_24_22
Shyam Kukreja
{"title":"Need for COVID-19 vaccination in children","authors":"Shyam Kukreja","doi":"10.4103/cmrp.cmrp_24_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_24_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":"93 1","pages":"49 - 52"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81685359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Three-Dimensional (3D) scanning applications for COVID-19 pandemic COVID-19大流行的三维扫描应用程序
Pub Date : 2022-03-01 DOI: 10.4103/cmrp.cmrp_72_20
Abid Haleem, M. Javaid
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引用次数: 0
期刊
Current medicine research and practice
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