Spectrum of neurological disorders admitted in Tribhuvan University Teaching Hospital Maharajgunj

Bp, Gajurel; Parajuli, Pawan; Nepali, Rabin; Oli, K K

doi:10.3126/jiom.v34i3.8918

Cited by 11 publications

(9 citation statements)

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“…The most common cause of out-patient visits was stroke (98.2%), which is similar to previous studies [ 11 , 12 , 14 , 16 , 19 ]. According to WHO estimates in 2001, 86% of deaths related to stroke worldwide occurred in developing countries [ 20 ].…”

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confidence: 90%

Pattern of neurological diseases in adult outpatient neurology clinics in tertiary care hospital

et al. 2017

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ObjectivesThe burden of neurological diseases in developing countries is rising although little is known about the epidemiology and clinical pattern of neurological disorders. The objective of this study was to understand the burden of disease faced by neurologists a in tertiary care setting.ResultsA prospective observational study was conducted of all presentations to neurology clinics at Aga Khan University Hospital Karachi over a period of 2 years. A total of 16,371 out-patients with neurological diseases were seen during the study period. The mean age of the study participants were 46.2 ± 18.3 years and 8508 (52%) were male. Headache disorders were present in 3058 (18.6%) of patients followed by vascular diseases 2842 (17.4%), nerve and root lesions 2311 (14.1%) and epilepsies 2055 (12.5%). Parkinson’s disease was more prevalent in male participants 564 (70.8%) as compared to female 257 (62.1%) (p = 0.002). Migraines and vertigo disease were more diagnosed in females as compared to males. Epilepsies were seen more in younger age groups. Parkinson’s disease was seen in 50.9% of participants between the ages of 45 and 65 years, and the frequency increased with age.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2873-5) contains supplementary material, which is available to authorized users.

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Section: Main Textsupporting

confidence: 90%

Pattern of neurological diseases in adult outpatient neurology clinics in tertiary care hospital

et al. 2017

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“…Cerebrovascular diseases are the largest cause of neurological admissions worldwide, with frequencies ranging from 47.5 to 62%. Infectious diseases and seizures alternate in the second and third position, ranging from 3.9 to 21.8% and 4.8 to 9.8%, respectively 10 , 11 , 12 , 13 . In one of the few Brazilian inpatient series available, the cerebrovascular group was the most prevalent, with a frequency of 51% 14 .…”

Section: Discussionmentioning

confidence: 99%

What can be expected to be seen in a Neurology ward? Eleven-year experience in a Brazilian university hospital

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Oliveira

Coelho

et al. 2021

Arq. Neuro-Psiquiatr.

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Background: Neurological disorders are significant causes of morbidity and mortality worldwide. However, data about general neurological inpatient admissions in Brazil is limited. Objective: To investigate the prevalence of neurological disorders according to disease group and lesion site among patients admitted to a general Neurology ward. Methods: This was an observational and descriptive study. The hospital discharge database for the Neurology ward was surveyed in accordance with the International Classification of Diseases, 10th edition (ICD-10), from September 2008 to October 2019. The final diagnosis was classified into neurological disorder groups and site. Results: Overall, 2,606 clinical neurological patient files were included, with mean length of hospitalization of 16.7 days and a total of 325 readmissions (12.5%). The overall mortality rate in the ward was 3.8% (100 patients). Among all the diagnoses, cerebrovascular disease was the most prevalent (45.8%), followed by inflammatory disorders (22.2%). The brain was the most common lesion site (66.0%), followed by peripheral nerves (10.0%) and meninges and cerebrospinal fluid (7.7%). Conclusions: The disease pattern upon admission showed that a majority of the cases consisted of cerebrovascular disorders and that the brain was the most frequently affected structure, although we observed that a wide variety of cases were admitted, encompassing all neurological disorders.

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“…The majority of the burden of stroke continues to reside in developing countries comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs [2]. According to data of the central referral hospital of Nepal, ischemic stroke accounted for 36.5% of all admitted cases in neurology ward and 73.8% of all admitted cases of stroke [3].…”

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confidence: 99%

Status of prehospital delay and intravenous thrombolysis in the management of acute ischemic stroke in Nepal

et al. 2019

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Background Intravenous thrombolysis has been recently introduced in Nepal for the management of acute ischemic stroke. Pre-hospital delay is one of the main reasons that hinder thrombolytic therapy. The objective of this study was to evaluate the status of prehospital delay and thrombolysis in Nepal. Methods Data were prospectively collected from patients of both genders, age > 18 years who arrived at the emergency department (ED) with symptoms and neuroimaging findings consistent with an ischemic stroke. Patient data were obtained from ED form and standard questionnaires were used to assess factors resulting in prehospital delay. Modified Rankin scale and National Institute of Health stroke scale were used to assess the degree of disability and severity of stroke respectively. Results A total of 228 patients were enrolled in the study between August 2017 and August 2018. Only 46 (20.17%) patients arrived within the time frame for thrombolysis. Onset at daytime (OR: 4.07; 95% CI: 1.65–10.1; p = 0.001), stroke symptoms facial deviation (OR: 5.03; 95% CI: 2.47 to 10.26; p = 0.000) and speech disturbances (OR: 2.34; 95% CI: 1.06 to 5.1; p = 0.021), identification of stroke (OR: 22.36; 95% CI: 9.42–53.04; p = 0.000), rushing to ED after onset of symptoms (OR: 2.93; 95% CI: 1.5–5.7; p = 0.001), awareness of treatment of stroke (OR: 10.21; 95% CI: 4.8–21.6; p = 0.000), direct presentation (OR: 4.2; 95% CI: 2.09–8.66; p = 0.000), the distance less than 20 km (OR: 7.9; 95% CI: 3.8–16.5; p = 0.000), and education above high school (OR:4.85; 95% CI: 2.2–10.5; p = 0.000) were associated with early arrival. Heavy traffic, income below 1000 USD per annum and diabetes mellitus were associated with delayed arrival to ED. Out of 46 early arrival patients, only 30 patients (13.15%) received tissue plasminogen activator during the study period, while others were deprived because of their inability to afford the treatment cost. Conclusion Community-based intervention to spread awareness, establishing comprehensive stroke centers, training specialists, improving emergency services, establishment of telestroke facilities and encouraging the use of low-cost tenecteplase as an alternative to alteplase can help improve care for stroke patients in Nepal.

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Spectrum of neurological disorders admitted in Tribhuvan University Teaching Hospital Maharajgunj

Cited by 11 publications

References 7 publications

Pattern of neurological diseases in adult outpatient neurology clinics in tertiary care hospital

Pattern of neurological diseases in adult outpatient neurology clinics in tertiary care hospital

What can be expected to be seen in a Neurology ward? Eleven-year experience in a Brazilian university hospital

Status of prehospital delay and intravenous thrombolysis in the management of acute ischemic stroke in Nepal

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