Who are dying and why? A case series study of maternal deaths in Nepal

ObjectivesTo identify delays and associated factors for maternal deaths in Nepal.DesignA cross-sectional case series study of maternal deaths. An integrated verbal and social autopsy tool was used to collect quantitative and qualitative information regarding three delays. We recorded death accounts and conducted social autopsy by means of community Focus Group Discussions for each maternal death; and analysed data by framework analysis.SettingSixty-two maternal deaths in six districts in three provinces of Nepal.ResultsNearly half of the deceased women (45.2%) were primiparous and one-third had no formal education. About 40% were from Terai/Madhesi and 30.6% from lower caste. The most common place of death was private hospitals (41.9%), followed by public hospitals (29.1%). Nearly three-fourth cases were referred to higher health facilities and median time (IQR) of stay at the lower health facility was 120 (60–180) hours. Nearly half of deaths (43.5%) were attributable to more than one delay while first and third delay each contributed equally (25.8%). Lack of perceived need; perceived cost and low status; traditional beliefs and practices; physically inaccessible facilities and lack of service readiness and quality care were important factors in maternal deaths.ConclusionsThe first and third delays were the equal contributors of maternal deaths. Interventions related to birth preparedness, economic support and family planning need to be focused on poor and marginalised communities. Community management of quick transportation, early diagnosis of pregnancy risks, accommodation facilities near the referral hospitals and dedicated skilled manpower with adequate medicines, equipment and blood supplies in referral hospitals are needed for further reduction of maternal deaths in Nepal.

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A Retrospective, Multicenter, Cross-Sectional Case Series Study Evaluating Outcomes of CAD/CAM Abutments on Implants from Four Manufacturers: 4-Year Mean Follow-up

The International Journal of Oral & Maxillofacial Implants ◽

10.11607/jomi.8840 ◽

2021 ◽

Vol 36 (5) ◽

pp. 966-976

Author(s):

Christopher Barwacz ◽

Kumar Shah ◽

Nurit Bittner ◽

William Parker ◽

Toni Neumeier ◽

...

Keyword(s):

Case Series ◽

Cross Sectional ◽

Case Series Study ◽

Cad Cam ◽

Series Study

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FGF-23 and PTH levels in patients with acute kidney injury: A cross-sectional case series study

Annals of Intensive Care ◽

10.1186/2110-5820-1-21 ◽

2011 ◽

Vol 1 (1) ◽

pp. 21 ◽

Cited By ~ 39

Author(s):

MaryAnn Zhang ◽

Raymond Hsu ◽

Chi-yuan Hsu ◽

Kristina Kordesch ◽

Erica Nicasio ◽

...

Keyword(s):

Acute Kidney Injury ◽

Case Series ◽

Kidney Injury ◽

Cross Sectional ◽

Case Series Study ◽

Fgf 23 ◽

Series Study

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Stillbirths at the National Referral Hospital in Bhutan: a historical description of the rate and related factors, 2006-2008

Bhutan Health Journal ◽

10.47811/bhj.38 ◽

2017 ◽

Vol 3 (1) ◽

pp. 19-23

Author(s):

Phurb Dorji ◽

Thinley Dorji

Keyword(s):

Case Series ◽

Referral Hospital ◽

Antenatal Visit ◽

Cross Sectional Survey ◽

Related Factors ◽

Cross Sectional ◽

Case Series Study ◽

Ethical Approval ◽

Series Study ◽

National Referral Hospital

Introduction: A fetal death or stillbirth is a baby born weighing >500 grams and with no signs of life at or after 28 weeks of gestation. Methods: This was a cross-sectional survey to estimate the rate of stillbirths and a case series study to describe all stillbirths occurring at Bhutan’s national referral centre, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), from June 2006 to July 2008. Ethical approval was granted by the Ministry of Health. All pregnant women who had stillbirths with fetuses weighing >500 grams were included. Antenatal and socio-demographic details and examination of the newborn were abstracted from records. Results: There were 96 stillbirths among 5,417 births at JDWNRH, for a rate of 17.72 per 1,000 births. The mean age of women with stillbirths was 26.5 years (range 15 to 44 years). The majority of stillbirths occurred in women aged between 20 to 34 years and in primipara. The majority (87.5%) of the women had at least one antenatal visit, 69.8% had at least two visits while 12.5% had zero antenatal visits. At birth, there were 39 fresh stillbirths and 57 macerated. Seventy-six stillborn babies (79.2%) had weight lesser than 2500 grams. The most common cause was congenital infections, severe pregnancy induced hypertension, prelabour premature rupture of membranes, chorioamnionitis, and prolonged rupture of membranes. Congenital anomalies causing death was relatively lower in rank. The proportion of unexplained stillbirths was 15.6%. Conclusions: The rate of stillbirth was substantially high in our population. Many of the causes of stillbirth were preventable and measures can be reinforced to improve birth outcomes.

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Is lack of patient knowledge a cause of poorly controlled diabetes mellitus?

10.53350/pjmhs211592302 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2302-2304

Author(s):

Muhammad Ahmad Tahir Ch ◽

Nauman Ismat Butt ◽

Hiba Shakeel ◽

Mehrun Nisa Fatima Gondal ◽

Hamdah Saeed ◽

...

Keyword(s):

Diabetes Mellitus ◽

Case Series ◽

Diabetic Patients ◽

Patient Knowledge ◽

Keywords Diabetes ◽

Cross Sectional ◽

Pakistani Population ◽

Case Series Study ◽

Study Population ◽

Series Study

Background: Diabetes is a chronic debilitating disease. A large percentage of Pakistani population suffers from this disease and its consequences. Awareness regarding the disease and its management is poor. Aim: To evaluate the awareness of diabetic patients presenting at Services Hospital regarding diabetes. Study design: Observational cross-sectional case-series study. Settings & duration: Department of medicine Services hospital, Lahore, from 01-07-2020 to 31-12- 2020. Methodology: We interviewed 100 diabetic patients who presented to the OPD/ER of the hospital. All the participants were selected randomly. A simple questionnaire was used to record the demographic details of the patients as well as their response to a series of 13 questions. The knowledge of the participants was taken to be good if they were able to answer at least 8 or more of the questions correctly. Results: Overall, a total of 100 adults were interviewed. The median age of the study population was 52.06 years with standard deviation of 13.49 years. There were 46 females and 54 males. Only 30% of the patients had sufficient knowledge regarding the disease and its complications. When stratification was done there was no significant association with any variable. Conclusion: There is a lack of knowledge among the diabetes regarding their disease. Even education from doctors is not helpful in this regard. Once patients are aware of the disease and its complications the glycemic control improves markedly. Keywords: Diabetes Mellitus, Poor Control, Patient Knowledge

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DENTAL FLOSS

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.11.1763 ◽

2016 ◽

Vol 23 (11) ◽

pp. 1364-1367

Author(s):

Shazia Parveen Rajpar ◽

Munir Ahmed Banglani ◽

Suneel Kumar Punjabi ◽

Miss Priya

Keyword(s):

Case Series ◽

Health Sciences ◽

Dental Students ◽

Cross Sectional ◽

Dental Floss ◽

Case Series Study ◽

Medical Health ◽

Knowledge And Practice ◽

Cleaning Methods ◽

Series Study

Objectives: To assist the concept and use of dental floss amongundergraduate dental students of Liaquat University of Medical & Health sciences,Jamshoro. Study Design: Cross-sectional, descriptive case series study. Setting:Institute of Dentistry, Liaquat University of Medical Health, Jamshoro, Pakistan.Period: June 2015 to December 2015. Methodology: In this study 192 studentsof BDS Department, Institute of Dentistry, Liaquat University of Medical & HealthScience, Jamshoro were selected. Questions related to assess the knowledge 87.14%students knew what dental floss was. Results: 74.29% students knew that dentalfloss remove plaque from interdental areas, whereas 25.71% replied don’t know.48.57% of the students thought that dental floss should be customarily used alongwith tooth brushing every day, 24.29% of the students thought that dental floss harmsthe interdental gingiva, whereas majority 40% said that it would not harm the gingiva,35.71% replied don’t know. only 18.57% respondent thought that toothbrushes withadvanced bristles designs would remove interdental plaque similar to dental floss,whereas majority (60%) of the respondent had no any idea about the effectiveness oftwo cleaning methods, practice of using dental floss 18.57% of students use interdentalaids commonly floss and while 81.43% did not use dental floss. 27.14% of the studysubjects use some other interdental aids like tooth picks to clean interdental areas,whereas 72.86% did not follow any other interdental cleaning practice. Conclusion:This study has focused light on the knowledge and practice of interdental aid, sofurther studies are needed. Finally, it could be concluded that awareness regardingdental floss needs to be bolstered in the population as preventive oral health carebehavior.

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Detection of SARS-CoV-2 in the tears and conjunctival secretions of Coronavirus disease 2019 patients

The Journal of Infection in Developing Countries ◽

10.3855/jidc.13224 ◽

2020 ◽

Vol 14 (09) ◽

pp. 977-981 ◽

Cited By ~ 1

Author(s):

Hüseyin Kaya ◽

Ahmet Çalışkan ◽

Mehmet Okul ◽

Tuğba Sarı ◽

İsmail Hakkı Akbudak

Keyword(s):

Case Series ◽

Cross Sectional Study ◽

University Hospital ◽

Cross Sectional ◽

Ocular Manifestations ◽

Case Series Study ◽

Eye Symptoms ◽

Polymerase Chain ◽

Mean Time ◽

Series Study

Introduction: Current studies suggest that tears and conjunctival secretions may be an important transmission route in coronavirus disease 2019 (COVID-19). The study aims to evaluate the presence of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) virus in tears and conjunctival secretion of patients with COVID-19. Methodology: A prospective interventional case series study was performed, and 32 patients with COVID-19 were selected at the Pamukkale University Hospital from 15 to 22 May 2020. The tear and conjunctival samples were collected by a conjunctival swab. Each specimen was sent to the laboratory for reverse transcription-polymerase chain reaction (RT-PCR) analyses. To avoid cross-infection, gloves and personal protective equipment were changed after collecting each sample. Results: 32 patients (18 male, 14 female) with Covid-19 were included in this cross-sectional study. The average age of the patients was 52.81 ± 16.76 years. By the time of the first collection of conjunctival-tear samples, the mean time of the onset of complaints was 6.84 ± 6.81 (1-35) days. Tear-conjunctival samples from 5 patients (16%) without conjunctivitis yielded positive PCR results, 3 of whom had positive and 2 negative nasopharyngeal PCR results. Conclusions: Five of 32 patients (16 %) without conjunctivitis or any eye symptoms had viral RNA in their tear-conjunctival samples. The possibility of transmission via tears and conjunctival secretions should be recognized even in the absence of conjunctivitis or other ocular manifestations.

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VIVAX MALARIA

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.05.1267 ◽

2015 ◽

Vol 22 (05) ◽

pp. 559-564

Author(s):

Ghulam Mustafa Mangrio ◽

Mushtaq Ali Memon ◽

Mumtaz Ali Shaikh ◽

Hamid Nawaz Ali Memon ◽

Suneel Arwani ◽

...

Keyword(s):

Vivax Malaria ◽

Case Series ◽

University Hospital ◽

Cross Sectional ◽

Distribution Width ◽

Male Predominance ◽

Case Series Study ◽

Combined Features ◽

The Common ◽

Series Study

Objective: To determine the frequency and severity of thrombocytopenia and toevaluate the variation of red cell distribution width (RDW) in patients with acute vivax malaria.Study Deign: Cross sectional descriptive case series study. Period: Six months. Setting:Liaquat University Hospital. Methods: All the patients with acute vivax malaria were evaluatedfor thrombocytopenia its severity and RDW. The data was analyzed in SPSS 10 and thefrequency and percentage was calculated. Results: Total 126 patients with acute vivax malariawere recruited, of which 88 were males and 38 were females. The mean age ±SD for male andfemale subjects was 44.76±6.83 and 40.83±7.42. The common features observed were fever31%, rigor 15% and combined features 14% (p=0.05). The thrombocytopenia was identified in86 patients of which 65 were males and 21 were females (p=0.04). The increased RDW wasobserved in 75 patients of which 57 were males and 18 were females (p=0.05). The bleedingwas detected in 56 and dyspnea and heart failure was found in 30 thrombocytopenic subjects(p=0.02). Regarding outcome 82 subjects were recovered while the 04 patients were expired(p=0.05). Regarding severity of thrombocytopenia majority 48.8% were in moderate categorywith male predominance (p=0.02). Conclusion: The thrombocytopenia and increased RDWwas observed in patients with acute vivax malaria.

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