Syncope: experience at a tertiary care hospital in Karachi, Pakistan

Patel, Muhammad Junaid; Khan, Nadeem Ullah; Samdani, Abdul Jawwad; Furqan, Muhammad; Hameed, Aamir; Khan, Muhammad Shoaib; Ayaz, Syed Imran; Jamil, Muhammad Omer

doi:10.1007/s12245-008-0015-5

Cited by 8 publications

(14 citation statements)

References 19 publications

(23 reference statements)

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“…This study also highlights that mortality is high and main reason is prescription drugs. The case fatality rate of 6.6% found in this study falls on the higher side of the 2.5 to 11% case fatality rates reported by other hospitals in Pakistan [ 10 - 14 , 22 - 24 ]. These findings also fall on the higher side of case fatality rates seen in neighboring countries like Sri Lanka (3.2%) and India (11%) [ 25 , 26 ].…”

Section: Discussioncontrasting

confidence: 70%

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

et al. 2015

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BackgroundAcute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments.MethodsThe data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. Information about patient demographics, type of poisoning agent, reason for poisoning and outcomes were collected using a standard questionnaire.ResultsAcute poisoning contributed to 1.2% (n = 233) of patients with intentional and unintentional injuries presenting to EDs of participating centers. Of these, 68% were male, 54% were aged 19 to 44 and 19% were children and adolescents (<18 years). Types of poisoning included chemical/gas (43.8%), drug/medicine (27%), alcohol (16.7%) and food/plant (6%). In half of all patients the poisoning was intentional. A total of 11.6% of the patients were admitted and 6.6% died.ConclusionPoisoning causes more morbidity and mortality in young adults in Pakistan compared to other age groups, half of which is intentional. Improving mental health, regulatory control for hazardous chemicals and better access to care through poison information centers and emergency departments will potentially help control the problem.

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Section: Discussioncontrasting

confidence: 70%

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

et al. 2015

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“…: 63% Poisoning, shooting 3% Syed et al (2008) [ 49 ] Retrospective case series (1990–2006) Karachi, Sindh DSH 69 0.59: 1 > 14 yrs. : 89.9% Poisoning, hanging, firearms 5.8% Shahid et al (2008) [ 89 ] Retrospective case series (2004) Karachi, Sindh DSH 98 0.58: 1 Mean age: 23.5 yrs Drug ingestion, organophosphate poisoning N/A Karamaliani et al (2008) [ 90 ] Cohort study Hyderabad, Sindh DSH 2 out of 2324 N/A N/A N/A N/A Patel et al (2008) [ 91 ] Retrospective case series (2002–2006) Karachi, Sindh DSH 202 0.69:1 Mean age: 17 yrs Benzodiazepines, anti-depressants 58.4% depression, 10.9% bipolar disorder Khan et al (2008) [ 28 ] Case-control (2003) Karachi, Sindh Suicide 100 cases 100 controls 4.88: 1 N/A Hanging, poisoning & firearms 96% Khurram et al (2008) [ 33 ] Cross-sectional (2006) Rawalpindi, Punjab DSH 60 0.72: 1 N/A Poisoning % not mentioned Shaikh et al (2008) Retrospective case series (2004–2006) Karachi, Sindh Unnatural deaths 99 out of 111 N/A N/A Poisoning N/A Zakiullah et al (2008) [ 92 ] Retrospective case series (1997–2002) Karachi, Sindh DSH 283 0.66: 1 12–15 yrs...…”

Section: Resultsmentioning

confidence: 99%

Suicide and deliberate self-harm in Pakistan: a scoping review

et al. 2018

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BackgroundSuicide is a major global public health problem with more than 800,000 incidents worldwide annually. Seventy-five percent of the global suicides occur in low and middle-income countries (LMICs). Pakistan is a LMIC where information on suicidal behavior is limited. The aim of the review is to map available literature on determinants, risk factors and other variables of suicidal behavior in Pakistan.MethodThis study was based on Arksey and O’Malley’s methodological framework of scoping review, combining peer reviewed publications with grey literature. Ten databases including Applied Social Sciences Index and Abstracts (ASSIA), Cochrane Trials Register (CRG), Cumulative Index to Nursing and Allied Health (CINAHL), National Library of Medicine Gateway (NLMG), ExcerptaMedica (EMBASE), National Library of Medicine’s MEDLINE (PUBMED), PSYCHINFO, Social Science Citation Index and Science Citation Index (SCI) and Pakmedinet.com were searched from the beginning of their time frames until December 2016 using a combination of key terms. The inclusion criteria included studies of various study designs covering different aspects of suicidal behavior in English language.ResultsSix hundred and twenty three articles were initially retrieved from all ten databases. Two independent reviewers screened the titles and abstracts for relevance. One hundred and eighteen articles were read in full, out of which 11 were excluded because they did not fit the eligibility criteria. One hundred and ten articles, including two student theses and one report, were included in the final review. Most studies were descriptive in nature, with only three that used a case-control design. Majority of the studies were from urban areas, and addressed determinants rather than risk factors. Gender differences and age were predominantly reported, with more males committing suicide. Suicidal behavior was more common among individuals younger than 30 years of age. The three most common methods for suicides were hanging, poisoning and use of firearms. Mental illness as a risk factor for suicides was mentioned in only three studies.ConclusionsThis review is the first attempt to synthesize available literature on suicidal behavior in Pakistan. The evidence is limited, and calls for more robust analytical research designs, along with a focus on risk factors.

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“…[1] Worldwide, ADEs or drug related injuries account for a large number of hospital admissions annually. [4], [5] In a recently published study from Karachi, 38% of patients admitted to a tertiary care center with drug toxicities were secondary to accidental overdose. [2] These adverse events can occur in both in-patients and out-patients.…”

Section: Introductionmentioning

confidence: 99%

Patients’ Insight of Interpreting Prescriptions and Drug Labels - A Cross Sectional Study

et al. 2013

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BackgroundErrors in consuming drugs are associated with significant morbidity and mortality, besides an impact on the already overburdened health-care system. Misunderstanding drug labels and prescriptions plays an important role in contributing to adverse drug events.ObjectiveTo evaluate abilities to understand prescriptions and drug labels among patients attending tertiary care hospital in Karachi.MethodsA cross sectional study was conducted at the Aga Khan University Hospital (AKUH), from January to March 2009. After informed consent, 181 adult patients and their healthy attendants were interviewed at AKUH using a standardized questionnaire, which ascertained patient demographics, factors that might increase exposure to health-care personnel as well as the basic knowledge and understanding of prescriptions and drug labels.ResultsOut of 181, majority 137(76%) had received graduate or post-graduate degrees. 16 (9%) had received no formal education; of which all were females and 89(84%) of the total females were housewives. Overall, 130(72%) followed only a single doctor’s prescription. Majority failed to understand various medical terminologies related to dosage. In the high literacy group, 45(33%) understood once daily OD (p = 0.003), 27(20%) thrice daily TID (p = 0.05), 29(21%) twice daily BD (p = 0.01), 31(23%) thrice daily TDS (p = 0.002) and 43(31%) as needed SOS (p = 0.003) as compared to the group with no formal education, who were unable to comprehend the terms. The most common reason for using more than one prescription was decreased satisfaction with the doctor in 19(39%) and multiple co-morbids as responded by 17(35%) of patients. Knowledge regarding various medical terminologies used for dosage and routes of drug administration were also understood more frequently among the English medium respondents. The elderly identified medicine through color (47%, p<0.001), and were less likely to understand drug indications (p = 0.05) compared to younger subjects.ConclusionUnderstanding of drug prescriptions is alarmingly low in the community, even amongst the educated. Care givers need to revisit this often ignored aspect of patient care.

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Syncope: experience at a tertiary care hospital in Karachi, Pakistan

Cited by 8 publications

References 19 publications

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

Intentional and unintentional poisoning in Pakistan: a pilot study using the Emergency Departments surveillance project

Suicide and deliberate self-harm in Pakistan: a scoping review

Patients’ Insight of Interpreting Prescriptions and Drug Labels - A Cross Sectional Study

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