Morbidity pattern and household cost of hospitalisation for non-communicable diseases (NCDs): a cross-sectional study at tertiary care level.

OBJECTIVE: To determine the pattern of morbidity and the demographic and socioeconomic characteristics of patients seeking in-patient services for noncommunicable diseases (NCDs) in medical units of a tertiary care hospital, and to estimate the economic burden imposed by these admissions on the households. METHODS: A descriptive cross-sectional study was conducted in medical units of the Colombo North Teaching Hospital, Ragama. Data were collected using a pre-tested interviewer-administered questionnaire. Morbidity patterns and demographic and socio-economic characteristics of patients with NCDs were determined. Direct and indirect components of the household cost of hospital stay were estimated. RESULTS: Fifty five per cent of the patients men male and the largest age group (11%) was 50-54 years. Seventy per cent were above 40 years of age, and 63% represented social classes 4 and 5. Diseases of the circulatory system were the commonest (31%). Median household cost of the total hospital stay was Rs. 852.00 (inter-quartile range Rs. 351.00-1885.00) of which 70% were direct costs. Median daily cost was Rs. 340.00 (interquartile range Rs.165.00-666.00). Only 44% of patients incurred an indirect cost. Cost of travelling was the main contributor (36%) to the household cost. Laboratory investigations contributed 16%. CONCLUSIONS: Most patients seeking in-patient services were from a poor socioeconomic background. The economic burden imposed by the admission to the household was mainly due to direct costs incurred for travelling and investigations.

Dengue fever associated with a haematoma of the rectus abdominis muscle.

We describe a patient with dengue fever with a haematoma of the rectus abdominis muscle, due to a tear in the inferior epigastric artery following episodes of retching. From the literature reviewed, we noted that there are no previous reports of dengue fever associated with muscle haematomas.

A man with thyrotoxicosis, lymphoma and thymic hyperplasia.

We report a case of non-Hodgkin's lymphoma of Burkitt's type with thyrotoxicosis and thymic hyperplasia in a 27-year old man. As far as we are aware this is the first reported case of Burkitt's lymphoma, thymic hyperplasia and thyrotoxicosis occurring in the same patient.