scholarly journals Head Circumference of Babies at Birth in Nigeria

2019 ◽  
Vol 65 (6) ◽  
pp. 626-633 ◽  
Author(s):  
Victor Chung Pam ◽  
Christopher Sabo Yilgwan ◽  
David Danjuma Shwe ◽  
IbrahimIshaya Abok ◽  
Nathan Shehu ◽  
...  
Keyword(s):  
Reference Values ◽  
Gestational Age ◽  
Head Circumference ◽  
Care Center ◽  
Large Population ◽  
Local Population ◽  
Tertiary Care ◽  
Age Groups ◽  
Newborn Care ◽  
University Teaching

Abstract Background and Objectives Measuring head circumference (HC) of newborns is an important tool for evaluating intra-uterine brain development. HC reference charts currently in use in Nigeria are not representative of the local population. We thus present locally derived HC reference data for Nigerian infants at birth. Subjects and Methods We reviewed birth records of all infants at the Jos University Teaching Hospital (JUTH) over a 10 year period from January 2006. JUTH is a tertiary care center offering obstetric services to a large population of women in Jos and its environs. All births with gestational age between 28 and 42 weeks were included in the study. STATA version 14 was used to calculate gestational age associated HC percentile measurements. Results We included 18 282 babies to generate the reference values. The mean HC value was 34.4 ± 2.1 cm (M = 34.6 ± 2.16 cm, F = 34.1 ± 2.02 cm, p < 0.001). Our HC reference values significantly differ from the USA and INTERGROWTH-21 charts currently in use in our country. Mean HC was higher in male infants compared with female infants. This difference was uniformly so across all gestational age groups. Conclusions The use of our locally derived HC reference values could be more appropriate in defining normal head growth in Nigerian infant populations thereby improving newborn care.

scholarly journals Prevalence of voice disorders in tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 143
Author(s):  
Susmita Shrestha ◽  
Bijaya Kharel ◽  
Yogendra Amatya ◽  
Anil K. Adhikary ◽  
Yogesh Neupane
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Voice Disorders ◽  
University Teaching ◽  
Voice Disorder ◽  
Care Hospital ◽  
Professional Voice Users ◽  
And Gender ◽  
Professional Voice

<p class="abstract"><strong>Background:</strong> Human voice is unique due to laryngeal configuration. However, change in voice is common with age and gender. It can also be altered by vocal abuse and misuse leading to different types of voice disorders. So, the present study aims to study the prevalence of voice disorder in patients visiting the voice clinic ENT-HNS department of Tribhuvan University Teaching Hospital tertiary care center.  </p><p class="abstract"><strong>Methods:</strong> This was a retrospective study carried out among the patients visiting voice clinic in the department of ENT-HNS for a duration of one year. The patients were evaluated for voice disorder by a team of ENT doctors and Speech pathologists using perceptual and instrumental evaluation. The patients who required surgical intervention were excluded. A descriptive study was done among patients with voice disorders requiring voice therapy.  </p><p class="abstract"><strong>Results:</strong> Out of 296 patients, the most common age group was 25-50 years with more females compared to males. Structural cause for voice disorder was most common in all age groups and gender in both professional and non-professional voice users but it was more prevalent in professional voice users.</p><p class="abstract"><strong>Conclusions:</strong> Voice disorders were more frequent in females than males and also in professional voice users as they tend to use voice more daily. The structural cause for voice disorder is the major cause of voice problems in all age groups.  </p>

scholarly journals Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

2021 ◽  
Vol 27 ◽  
pp. 107602962110228
Author(s):  
Bushra Moiz ◽  
Ronika Devi Ukrani ◽  
Aiman Arif ◽  
Inaara Akbar ◽  
Muhammed Wahhaab Sadiq ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Activated Protein C ◽  
Positive Association ◽  
Cerebral Venous Sinus Thrombosis ◽  
P Value ◽  
Middle Income ◽  
Duration Of Symptoms

Pediatric cerebral venous sinus thrombosis (CVST) is rare but a potentially fatal disease requiring its understanding in local setting. In this study, we observed the clinical course, management, and outcome of pediatric patients with sinus thrombosis in a tertiary care center at Pakistan. Patients between age 0 to 18 years of both genders diagnosed with sinus thrombosis during 2011 to 2020 were included. Data was collected through in-house computerized system and SPSS version 19 was used for analysis. Of 143492 pediatric admissions, 32 (21 males and 11 females) patients with a median (IQR) age of 4.5 years (0-16) had CVST. This is equivalent to 18.5 CVST events per million pediatric admissions. Adolescents were mostly affected, and the overall mortality was 7%. Primary underlying disorders were infections (59%), hematological neoplasms (12.5%), thrombotic thrombocytopenic purpura (3%) and antiphospholipid syndrome (3%). Activated protein C resistance (44%) was the most common inherited thrombophilia. Twenty-one (66%) patients were anemic with a mean (±SD) hemoglobin of 9.0 g/dL (±2.3). Regression analysis showed a positive association of anemia with multiple sinus involvement ( P-value 0.009) but not with duration of symptoms ( P-value 0.344), hospital stay ( P-value 0.466), age ( P-value 0.863) or gender ( P-value 0.542) of the patients. SARS-COV2 was negative in patients during 2020. Adolescents were primarily affected by sinus thrombosis and infections was the predominant risk factor for all age groups, with a low all-cause mortality. A high index of clinical suspicion is required for prompt diagnosis and intervention.

scholarly journals Complications and Outcome of Pregnancy in Extremes of Reproductive Age Groups: Experience at Tertiary Care Center

2016 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Manju Lata Verma ◽  
Sabuhi Qureshi ◽  
Uma Singh ◽  
Nisha Singh ◽  
Pushpa Lata Sankhwar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Reproductive Age ◽  
Tertiary Care Center

scholarly journals Male Fertility and Reduction in Semen Parameters: A Single Tertiary-Care Center Experience

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
D. Milardi ◽  
G. Grande ◽  
D. Sacchini ◽  
A. L. Astorri ◽  
G. Pompa ◽  
...  
Keyword(s):  
Reference Values ◽  
Male Fertility ◽  
Ethical Issues ◽  
Semen Analysis ◽  
Care Center ◽  
Tertiary Care ◽  
Healthcare Services ◽  
University Hospital ◽  
Semen Parameters ◽  
Spontaneous Conception

Background. Infertility is both a clinical and a public problem, affecting the life of the couple, the healthcare services, and social environment. Standard semen analysis is the surrogate measure of male fertility in clinical practice.Objective. To provide information about the relationship between semen parameters and spontaneous conception.Methods. We evaluated retrospectively 453 pregnancies that occurred among 2935 infertile couples evaluated at an infertility clinic of a tertiary-care university hospital, between 2004 and 2009.Results. Normal semen analysis was present only in 158 patients; 295 subfertile patients showed alterations in at least one seminal parameter. A reduction in all seminal parameters was observed in 41 patients. Etiological causes of male infertility were identified in 314 patients.Conclusion. Our data highlights the possibility of a spontaneous conception with semen parameters below WHO reference values. Therefore, we support the importance of defining reference values on a population of fertile men. Finally, we analyzed the related ethical issues.

scholarly journals Immunoglobulin A (IgA) Nephropathy in Protocol Graft Kidney Biopsy done at six months Post Transplantation in a Tertiary Care Center Hospital of Nepal

2017 ◽  
Vol 6 (1) ◽  
pp. 6-11
Author(s):  
Midhan Shrestha ◽  
Dibya Singh Shah
Keyword(s):  
Iga Nephropathy ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
University Teaching ◽  
Time Interval ◽  
Post Transplantation ◽  
Protocol Biopsy ◽  
Post Transplant

Background: Renal transplantation is the treatment of choice for end stage renal disease. The focus of interest has been to increase the life of the transplanted graft. Recurrence of native kidney disease or occurrence of denovo glomerulonephritis has adverse effects in graft survival. Protocol graft biopsy done at fixed time interval after transplantation aids in early identification of post-transplant glomerulonephritis before development of clinical signs and symptoms. This study describes the incidence of post-transplant IgA Nephropathy in protocol renal graft biopsies done at six months post- transplantation.Materials and Methods: This is a hospital based observational descriptive study, done in Tribhuvan University Teaching Hospital, Kathmandu, Nepal, a tertiary medical referral center in the capital. Protocol biopsy of the graft kidney was performed at six months post-transplantation in all recipients who underwent kidney transplantation in this hospital between 2071 Kartik and 2072 Ashwin.Results: Protocol biopsy was performed in total 47 recipients. Mean age of the recipients was 33.7 years ±10.83 years. The study population consisted of 33 (70.2%) male and 14 (29.8%) female recipients. IgA Nephropathy was present in 6 (12.8%) recipients.Conclusion: Our study demonstrates that IgA Nephropathy does occur in patients with stable GFR and without any clinical or laboratory abnormalities. Protocol biopsy is valuable in detection of early histologic abnormalities before onset of clinical manifestations, thus helping in prompt management with aim to prolong the graft survival.Journal of Nobel Medical CollegeVolume 6, Number 1, Issue 10 (January-June, 2017)

Death in delirious palliative-care patients occurs irrespective of age: A prospective, observational cohort study of 229 delirious palliative-care patients

2020 ◽  
pp. 1-9
Author(s):  
Annina Seiler ◽  
David Blum ◽  
Caroline Hertler ◽  
Markus Schettle ◽  
Carl Moritz Zipser ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Observational Cohort Study ◽  
Adverse Outcomes ◽  
Prospective Observational Cohort Study ◽  
Precipitating Factors ◽  
Observational Cohort

Abstract Objectives Patients with terminal illness are at high risk of developing delirium, in particular, those with multiple predisposing and precipitating risk factors. Delirium in palliative care is largely under-researched, and few studies have systematically assessed key aspects of delirium in elderly, palliative-care patients. Methods In this prospective, observational cohort study at a tertiary care center, 229 delirious palliative-care patients stratified by age: <65 (N = 105) and ≥65 years (N = 124), were analyzed with logistic regression models to identify associations with respect to predisposing and precipitating factors. Results In 88% of the patients, the underlying diagnosis was cancer. Mortality rate and median time to death did not differ significantly between the two age groups. No inter-group differences were detected with respect to gender, care requirements, length of hospital stay, or medical costs. In patients ≥65 years, exclusively predisposing factors were relevant for delirium, including hearing impairment [odds ratio (OR) 3.64; confidence interval (CI) 1.90–6.99; P < 0.001], hypertonia (OR 3.57; CI 1.84–6.92; P < 0.001), and chronic kidney disease (OR 4.84; CI 1.19–19.72; P = 0.028). In contrast, in patients <65 years, only precipitating factors were relevant for delirium, including cerebral edema (OR 0.02; CI 0.01–0.43; P = 0.012). Significance of results The results of this study demonstrate that death in delirious palliative-care patients occurs irrespective of age. The multifactorial nature and adverse outcomes of delirium across all age in these patients require clinical recognition. Potentially reversible factors should be detected early to prevent or mitigate delirium and its poor survival outcomes.

scholarly journals Pancreatic Surgery in the Older Population: A Single Institution’s Experience over Two Decades

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Bhaumik Brahmbhatt ◽  
Abhishek Bhurwal ◽  
Frank J. Lukens ◽  
Mauricia A. Buchanan ◽  
John A. Stauffer ◽  
...  
Keyword(s):  
Pancreatic Resection ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
The Elderly ◽  
Age Group ◽  
Pancreatic Resections ◽  
Increased Risk ◽  
Younger Patient ◽  
Two Age Groups

Objectives. Surgery is the most effective treatment for pancreatic cancer. However, present literature varies on outcomes of curative pancreatic resection in the elderly. The objective of the study was to evaluate age as an independent risk factor for 90-day mortality and complications after pancreatic resection. Methods. Nine hundred twenty-nine consecutive patients underwent 934 pancreatic resections between March 1995 and July 2014 in a tertiary care center. Primary analyses focused on outcomes in terms of 90-day mortality and postoperative complications after pancreatic resection in these two age groups. Results. Even though patients aged 75 years or older had significantly more postoperative morbidities compared with the younger patient group, the age group was not associated with increased risk of 90-day mortality after pancreatic resection. Discussion. The study suggests that age alone should not preclude patients from undergoing curative pancreatic resection.

scholarly journals Characterization of the motor performance of newborns in a neonatal unit of tertiary level

2016 ◽  
Vol 62 (6) ◽  
pp. 553-560
Author(s):  
Luciana Giachetta ◽  
Carla Marques Nicolau ◽  
Regina Célia Turola Passos Juliani ◽  
Werther Brunow de Carvalho ◽  
Vera Lúcia Jornada Krebs
Keyword(s):  
Reference Values ◽  
Gestational Age ◽  
Motor Performance ◽  
Age Groups ◽  
Neonatal Unit ◽  
Tertiary Level ◽  
Significant Difference ◽  
Performance Results

Summary Objective: To characterize the motor performance of newborns in a neonatal unit of tertiary level and compare the results to the values recommended by the Test of Infant Motor Performance (TIMP). Method: Newborns between 34 and 416/7 weeks of corrected gestational age, breathing spontaneously and presenting state of consciousness 4 or 5, according to Brazelton, were included. TIMP was used to evaluate the motor performance. Results: The age groups of 34-35 and 36-37 weeks showed on average TIMP scores similar to the reference values (p>0.05), while in the age groups of 38-39 weeks and 40-41 weeks TIMP scores were statistically lower than the reference values (p<0.001 and p=0.018, respectively). The 34-35 and 36-37 week groups were rated as average, while the 38-39 and 40-41 week groups were defined as low average. Classifications below average and very below average were not observed. Conclusion: The newborns showed average scores compared to the TIMP reference values; however, there were two groups whose performances were within the low average. There was no significant difference in motor performance of newborns in the age groups of 38-39 and 40-41 weeks. This behavior suggests that the sample studied has special features that possibly negatively influenced their motor performance. The results showed that the TIMP is a very useful tool and can be used safely in tertiary neonatal units.

scholarly journals Sonographic Reference Values for Fetal Transverse Cerebellar Diameter in the Second and Third Trimesters in a Nigerian Population

2017 ◽  
Vol 33 (3) ◽  
pp. 174-181 ◽  
Author(s):  
Charles Ugwoke Eze ◽  
Queendaline Ebere Onwuzu ◽  
Innocent Uchechukwu Nwadike
Keyword(s):  
Reference Values ◽  
Gestational Age ◽  
Head Circumference ◽  
Outer Margin ◽  
Menstrual Period ◽  
Last Menstrual Period ◽  
Abdominal Circumference ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Nigerian Population

This study aimed to establish reference values of fetal transverse cerebellar diameter (TCD) in a Nigerian population. A cross-sectional convenience study was carried out between June 2013 and May 2014 in Enugu, Nigeria. The sonographic examinations were performed on 697 pregnant women with gestational ages between 14 and 40 weeks. The TCD measurements were obtained from the proximal outer margin to the distal outer margin of cerebellum. The women’s last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference were also recorded. The mean (standard deviation) TCD increased from 13.6 (2.2) mm to 27.3 (2.6) mm and 28.9 (2.0) mm to 42.9 (2.0) mm in the second and third trimesters, respectively. The relationship of TCD with gestational age obtained from last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference was determined. The TCD had a strong correlation with gestational age ( r = .93; P < .05). Reference values for TCD were established for those patients who attended this clinic. This is a likely data set to use for future research that could focus on similar practices and in other regions of the country for possible generation of a nationwide nomogram.

scholarly journals Incidence and risk factors of hypoglycemia among neonates: a hospital based prospective study

2021 ◽  
Vol 8 (6) ◽  
pp. 1014
Author(s):  
Sandeep Gada ◽  
Dnyaneshwar Potpalle ◽  
Priyanka Gunda
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Prospective Study ◽  
Gestational Age ◽  
Care Center ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Physical Growth ◽  
Basic Care ◽  
Lower Segment Cesarean Section

Background: Among neonates, one of the common metabolic problem is hypoglycemia. Hence basic care of the neonate involves monitoring of blood glucose. If not diagnosed and treated early, it may lead to problems associated with physical growth and neurodevelopment. The objective was to study incidence and risk factors of hypoglycemia among neonates.Methods: This was a prospective study carried out at a tertiary care center. 100 neonates were included. Standard glucometer was used to measure blood glucose in mothers and neonates. For mothers, it was measured at time of delivery. For neonates, it was measured at zero, three, six, twelve and twenty four hours of birth. Standard treatment protocol was followed for neonatal hypoglycemia.Results: Incidence of hypoglycemia at birth was 17%. As maternal blood glucose increased, neonatal glucose decreased. Important risk factors found for hypoglycemia in neonates were being born by lower segment cesarean section (LSCS), low for gestational age (LGA) babies and small for gestational age (SGA) babies, pre-term and post term babies. But these risk factors were not found to be statistically significant (p>0.05).Conclusions: Blood glucose varied widely in the neonates. Important risk factors found for hypoglycemia in neonates were being born by LSCS, LGA babies and SGA babies, pre-term and post term babies.

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