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Introduction: Delirium and confusional states are among the most common mental disorders encountered in patients with acute medical illness, particularly among those who are older. We report a case of tramadol induced acute delirium in a patient admitted in the emergency ward which was managed by stoppage of the offending drug. Case report: A 62 year old male presented to the emergency ward with complaints of acute abdominal pain and ultrasonography revealed cholithiasis. All other investigations were unremarkable and the patients was put on conservative management including tramadol for pain relief. Few hours later, the patient developed confusion, violent behavior, and started talking irrelevantly, which subsided after he was sedated with lorazepam. Next morning, after receiving another dose of injectable tramadol, the patient again developed delirium with similar symptoms as the night before. After thorough psychiatric consultation he was diagnosed with tramadol induced delirium. As a result, tramadol was discontinued and the patient recovered completely. Conclusion: Tramadol, a commonly used analgesic in emergency and surgical settings, can lead to delirium. It is important for emergency physicians to have a high index of suspicion so that they can promptly identify the offending drug and take corrective measures.

Objective: To study knowledge, attitudes, and practices (KAP) of evidence-based practice (EBP) among health-care professionals (HCPs). Materials and Methods: In this cross-sectional study, a pre-tested questionnaire regarding KAP related to EBP was administered to HCPs. The responses were compared based on level of education, work profile and years of experience. Results: Out of 93 HCPs (47.31% male), 64 (68.82%) were Doctor of Medicine or Master of Surgery and 63 (69.23%) were in clinical practice. Thirteen (14%) had experience of <5 years. Eighty seven (93.55%) HCPs were aware about the term “EBP.” Fifty-three (56.99%) were aware about core elements of EBP with significant difference in responses based on level of education (P < 0.0001). Sixty-two (66.67%) had understanding regarding usage of research findings in clinical practice with significant difference based on the level of education (P = 0.003586). Forty-five (48.39%) reported having discussions at workplace about EBP with significant difference based on level of education (P = 0.03991). Seventy-one (76.34%) HCPs responded that they ask patients about their preferences and consider them in decision-making. Eighty-two (88.17%) HCPs showed interest in improving knowledge of EBP with significant difference based on the highest level of education (P = 0.04043). Conclusion: In the studied population, awareness about the term “EBP” was good. There is further scope for improvement in literature search, understanding core elements of EBP, critical analysis of research findings, statistics, and knowledge to implement EBP. Most of the study population showed interest in improving knowledge about EBP.