Background: Substance abuse disorder is among the leading public health problems in modern day world as they cause enormous human suffering in terms of morbidity, mortality and economic loss; and threatens the very social fabric of almost all communities around the world and as such is a great threat to the global health, economy and peace. Like most social behaviours the etiology of substance abuse is complex, varying through time, geographical regions and by demographic characteristics. Among young people, students are the most vulnerable group as the initiation into substance abuse first starts during this period. Aims & Objective: To find out the prevalence and pattern of substance abuse and its association with various sociocultural and demographic variables. Material and Methods: Multi-stage random sampling method was adopted to select the study subjects. The study subjects were asked about the substance abuse and related socio-demographic variables by means of WHO model core questionnaire format and results were subjected to statistical analysis. Results: The overall lifetime prevalence of for substance abuse among college students was found to be 31.3%. Male students had significantly higher prevalence of substance abuse as compared to female counterparts(37.5% versus 19.6% respectively).The most common substance being abused was Tobacco products(22.5%) followed by solvents (10.0%), alcohol (6.2%), sedatives (5.9%), cannabis (4.4%), amphetamine products (2.1%), hallucinogens (0.5%) and cocaine (0.3%). Age, gender and family type were found to be strongly associated with substance abuse (p<0.001). Conclusion: Prevalence of substance abuse among college students is high and causes significant problems in this population; therefore there is necessity of targeted interventions to reduce this huge burden.
LOS sepsis is an important risk factor for thrombocytopenia in the NICU. Fungal and gram- negative sepsis are frequently associated with a decreased platelet count. Sepsis-induced thrombocytopenia is more common among LBW babies and preterm babies. The mortality rate is significantly related to degree of thrombocytopenia.
Background and Aims:Decreasing mortality in sick and ventilated neonates is an endeavor of all neonatologists. To reduce the high mortality in this group of neonates, identification of risk factors is important. This study was undertaken to find out the indications of ventilation and complications in ventilated neonates and also study possible predictors of outcome.Subjects:Age <1-month; mechanically ventilated; not having suspected metabolic disorders or congenital anomalies; excluding postoperative patients.Methods:Neonates consecutively put on mechanical ventilation during the study period (October 2011 to November 2013) enrolled. Primary disease of the neonates along with complications present listed. Clinical and laboratory parameters analyzed to find the predictors of mortality.Results:Total 300 neonates were ventilated. 52% were male. Mean age, weight, and gestational age were 21 ± 62 h, 2320 ± 846.2 g, and 35.2 ± 4.9 weeks, respectively. 130 (43%) neonates died. Respiratory distress syndrome (RDS) (31.1%), sepsis (22.7%), and birth asphyxia (18%) were the most common indications for ventilation. Mortality in ventilated patients with sepsis, pneumonia, RDS or birth asphyxia was 64.7%, 60%, 44.6%, and 33.3%, respectively. Weight <2500 g, gestation <34 weeks, initial pH <7.1, presence of sepsis, apnea, shock, pulmonary hemorrhage, hypoglycemia, neutropenia, and thrombocytopenia were significantly associated with mortality (P < 0.05). Resuscitation at birth, seizures, intra ventricular hemorrhage, pneumothorax, ventilator-associated pneumonia, PO2, or PCO2 did not have a significant association with mortality. On logistic regression, gestation <34 weeks, initial pH <7.1, pulmonary hemorrhage, or shock were independently significant predictors of mortality.Conclusions:Weight <2500 g, gestation <34 weeks, initial arterial pH <7.1, shock, pulmonary hemorrhage, apnea, hypoglycemia, neutropenia, and thrombocytopenia were significant predictors of mortality in ventilated neonates.
Objectives:(1) To determine the frequency of abnormal neuroimaging in children with new-onset afebrile and complex febrile seizures; (2) to draw a correlation between Electroencephalogram (EEG) and neuroimaging.Study Design:A hospital-based prospective study.Materials and Methods:A total of 276 children (6 months to 14 years of age), who presented with new-onset afebrile or complex febrile seizures, underwent EEG and neuroimaging [Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI)].Results:Generalized seizures constituted the major seizure group in our study – 116/276 (42%) – followed by partial seizures 86/276 (31.2%) and complex febrile seizure in 64/276 (23.2%). Generalized as well as partial seizures were more common in children aged 6-14 years, while complex febrile seizures were predominantly seen in children less than 6 years old. Most of the patients with generalized and partial seizures had EEG abnormalities, while EEG abnormalities were uncommon in patients with complex febrile seizures. A total of 27/276 (9.8%) patients with seizure disorder had abnormal CT scans and this abnormality was more common in patients with partial seizures. CT abnormality was seen more commonly in those patients who had an abnormal EEG. EEG and CT correlation showed that patients with abnormal EEG had higher rates of CT abnormality, ie, 16.1% (25/155). Abnormal MRI was seen in 32/157 (20.4%) of patients; accuracy of picking abnormality by MRI, when EEG was abnormal, was 24.8% (P<0.05).Conclusion:Our findings indicate that clinical examination and EEG results are good indicators for neuroimaging, and these can be used as one of the criteria for ordering neuroimaging in new-onset seizures.
A three year retrospective study was done to study snakebite envenomation among Kashmiri children. Ten children were admitted with snakebite. Snakebite was vasculotoxic in seven and mixed in two. Levantine viper bites were seen in five who had Grade 3 bites with severe local signs, severe coagulopathy and hypotension. Both environmental risk and seasonal incidence was observed.
Background: Pancytopenia is not a disease by itself; rather it describes simultaneous presence of anemia, leukopenia and thrombocytopenia resulting from a number of disease processes. Varieties of hematological and non-hematological disorders may affect bone marrow either primarily or secondarily, resulting in the manifestation of pancytopenia. The incidence of various hematological disorders causing pancytopenia varies due to geographical distribution and genetic predisposition. This study highlights the spectrum of causes, clinical presentation and bone marrow morphology of pancytopenia.Methods: This prospective observational study was conducted for a period of two years at Al-Ameen Medical College, Bijapur, Bangalore. During this period, fifty patients with a hematological diagnosis of pancytopenia were studied during period in the department of pathology.Results: Among the 50 cases studied, 35 were males and 15 were females. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was predominant blood picture. Bone marrow study showed 72% hypercellular marrow, 12% normocellular and 16% hypocellular marrow. The commonest cause for pancytopenia was megaloblastic anemia followed by iron deficiency anaemia and malaria.Conclusions: The present study concludes that detailed hematological investigations along with bone marrow examination in pancytopenic patients is helpful to diagnose or rule out the causes of pancytopenia.
The study has been conducted in neonatal intensive care unit of Sher-i-Kashmir Institute of Medical Sciences, which is a tertiary care hospital. Thrombocytopenia and other hematological abnormalities are very commonly observed in neonatal infections. The objective of the study is to determine the frequency and severity of thrombocytopenia and other hematological abnormalities in neonatal sepsis of different microbiological origins, and their impact on morbidity and mortality. During a period of five years we studied all the newborn babies admitted, with the diagnosis of sepsis, in neonatal intensive care unit. In every sepsis positive patient we observed neutrophil count, micro ESR, C-reactive protein, severity and duration of thrombocytopenia and their relation with the patient's hospital course, morbidity and mortality. Of 194 Culture positive cases 49 (25.25%) cases had leucopenia with 100% mortality; 93 (47.93%) had thrombocytopenia with mortality directly proportional to severity of thrombocytopenia. In neonates with fungal and Gram-negative sepsis thrombocytopenia was comparatively severe and prolonged. Different pathogens causing sepsis have different effects on hematologic parameters. Neonatal sepsis is frequently associated with thrombocytopenia. Neonatal sepsis with neutropenia or with thrombocytopenia is associated with higher mortality. These hematological parameters constitute a simple and cost effective diagnostic tool for neonatal sepsis and guide antibiotic therapy, platelet transfusion, blood transfusion and other modalities of treatment.
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