scholarly journals Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Niyaz Ashraf ◽  
Sandeep Kumar Mishra ◽  
Pankaj Kundra ◽  
P. Veena ◽  
S. Soundaraghavan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Maternal Mortality ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
College Hospital ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Tertiary Hospitals ◽  
The Mean ◽  
One Year

Background and Objectives.Critically ill obstetric patients are a particularly unique cohort for the intensivist. The objective of this study was to review the indications for admission, demographics, clinical characteristics, and outcomes of obstetric patients admitted to intensive care unit of a medical college hospital in southern India and to identify conditions associated with maternal mortality.Design.Retrospective analysis of pregnant/postpartum (up to 6 weeks) admissions over a 1-year result. We studied 55 patients constituting 11.6% of mixed ICU admissions during the study period.Results.The mean APACHE (acute physiology and chronic health evaluation) II score of patients at admission was 11.8. Most of the patients (76%) were admitted in the antepartum period. The commonest indications for ICU admission were obstetric haemorrhage (51%) and hypertensive disorders of pregnancy (18%). 85% of patients required mechanical ventilation and 78% required inotropic support.Conclusions.Maternal mortality was 13%, and the majority of the deaths were due to disseminated intravascular coagulation and multiorgan failure, following an obstetric haemorrhage. A dedicated obstetric ICU in tertiary hospitals can ensure that there is no delay in patient management and intensive care can be instituted at the earliest.

scholarly journals Peripartum hysterectomy: a five year review at a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3590
Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Suboptimal Care

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 

scholarly journals Socio-demographic Characteristics of Vesico-vaginal fistula (VVF) patients attended at a tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Medical College Hospital ◽  
Care Hospital ◽  
Vaginal Fistula ◽  
College Hospital ◽  
Medical College ◽  
The Mean ◽  
Vesico Vaginal Fistula

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117

Marital Satisfaction Among Spouses of Male Patients with Alcohol Dependence Syndrome

2019 ◽  
Vol 2 (02) ◽  
pp. 8-13
Author(s):  
Humayoon Akbar ◽  
Sudhakar S. ◽  
Shanthi B. ◽  
Khadeja Bi ◽  
Jayaseelan R. ◽  
...  
Keyword(s):  
Marital Satisfaction ◽  
Alcohol Dependence ◽  
Rural Areas ◽  
Tertiary Care ◽  
College Hospital ◽  
Medical College ◽  
Alcohol Dependence Syndrome ◽  
Male Patients ◽  
The Mean ◽  
Alcohol Dependent

BACKGROUND One third of Indians consume alcohol and there is an alarming annual increase in alcohol consumption. Majority of spouses of alcohol dependent males are also the primary care-takers of their husbands and are at risk of domestic violence. Marital dissatisfaction could reduce their involvement in getting their spouses treated for alcohol dependence. Our aim was to study the marital satisfaction among the spouses of patients with alcohol dependence. METHODOLOGY This study was conducted on spouses of male patients with alcohol dependence syndrome attending the psychiatry department of a tertiary care medical college hospital in Kanchipuram District in Tamilnadu. 200 consecutive male patients with alcohol dependence syndrome using the ICD 10 criteria were recruited. Severity of alcohol dependence was assessed using Short Alcohol Dependence Data (SADD). Marital satisfaction among the spouses was assessed using ENRICH Marital Satisfaction (EMS) Scale. Analysis of the data was done using Statistical Package for the Social Sciences (SPSS) version 22.0. RESULTS The mean age of alcohol dependent men and their spouses were 43.05±9.39 and 37.58±8.86 years respectively. Most of the spouses (83.5%) had done their primary education only and 50% were house-wives (unemployed). Majority of men earned between Rs.5000 to 10,000 and most of them were unskilled workers belonging to the lower socio-economic group in the rural areas. The mean SADD and EMS scores were 25.05 ± 8.891 and 31.76 ± 14.45 respectively. 74% of men in our study population were highly dependent on alcohol. Amongst the spouses of men with severe dependence 68.9% reported moderate and 28.3% reported low marital satisfaction. DISCUSSION and CONCLUSION Majority of alcohol dependent men suffered from severe dependence. An inverse relationship between marital satisfaction scores and severity of alcohol dependence was observed. Alcohol dependence and its severity was noted to have an adverse impact on marital satisfaction among spouses of the dependent patients.

scholarly journals Study of maternal and fetal outcome in antepartum eclampsia in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1108
Author(s):  
Aruna Rani R. ◽  
Dheeba Jayanthi R. ◽  
Eswari S.
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Obstetric Emergencies ◽  
One Year ◽  
A Prospective Study

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.

scholarly journals Obstetric Haemorrhage Related Maternal Mortality: A Two-Year Experience at a Teaching Hospital in Bangladesh

2021 ◽  
Vol 8 (2) ◽  
pp. 90-94
Author(s):  
Tahmina Ahmed ◽  
Nazmul Haque ◽  
Bithi Debnath ◽  
Samsunnahar Begum
Keyword(s):  
Maternal Mortality ◽  
Economic Condition ◽  
Haemorrhagic Shock ◽  
Obstetric Hemorrhage ◽  
College Hospital ◽  
Maternal Deaths ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Rupture Of Uterus ◽  
The Common

Background: Bangladesh is one of the developing countries where the maternal mortality is extraordinarily high. Objectives: This study was conducted to find out the number and cause of obstetric haemorrhage related maternal death. Methodology: This retrospective study was conducted in the department of obstetrics & gynaecology at M.A.G Osmani Medical College Hospital, Sylhet, Bangladesh from January 2006 to December 2007. From all maternal deaths related to pregnancy occurred in that period, only death due to obstetric hemorrhage were enrolled. Thereafter, the records of hemorrhage related death patients were scrutinized and data were collected from death register. All necessary information was collected in a pre-designed clinical data sheet and analyzed. Results: Among all deaths in obstetric unit, maternal mortality due to obstetric haemorrhage was 32.09%. The deaths were common among multipara (3-4) in 26-30 years age group. Most of them were from lower socio-economic condition having no or irregular antenatal checkup. Among the causes of obstetric haemorrhage, PPH was the commonest. Atonic uterus was the main cause of PPH. Injudicious use of oxytocin and obstructed labour were the common cause of rupture of uterus. Although the causes of haemorrhage were different, most of the patients died due to haemorrhagic shock. Conclusion: This study helps to detect the magnitude of problem and major causes of maternal deaths specially haemorrhage related maternal deaths. Journal of Current and Advance Medical Research, July 2021;8(2):90-94

scholarly journals Clinical study of the correlation of foot length and birth weight among newborns in a tertiary care hospital

2017 ◽  
Vol 4 (3) ◽  
pp. 979
Author(s):  
Gowri S. ◽  
Kumar G. V.
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Anthropometric Measurement ◽  
Care Hospital ◽  
College Hospital ◽  
Foot Length ◽  
Low Birth Weight Babies ◽  
The Mean

Background: Gestational age and birth weight are the two most useful parameters for assessing maturity of the newborn. Major causes of neonatal mortality are diseases associated with low birth weight babies (LBW). It has been shown that foot length measurement is particularly valuable in premature babies who are so ill that conventional anthropometric measurements cannot be carried out due to the incubator and intensive care apparatus. Methods: The cross-sectional study was conducted in the department of pediatrics Sri Siddhartha Medical College Hospital, Tumkur, India. The birth weight in grams and length of the foot were documented in centimeters. Data was collected using standard proforma.Results: A total of 600 neonates were studied of which, males were 54.67 % (328) and females were 45.33 % (272). The neonates weighing less than 2.5 kg had a mean foot length of 6.94. The mean foot length for neonates weighing between 2.5 to 3.5 was 7.68. The mean foot length for neonates weighing more than 3.5 kg was 8.2cm. The correlation coefficient of birth weight with foot length was maximum in low birth weight babies (r= 0.94).Conclusions: The foot length is an efficient screening tool in identifying low birth weight babies. Foot length is a simple, quick and reliable anthropometric measurement which can be used as a proxy measurement to birth weight especially in sick and pre-term neonates receiving intensive care. 

scholarly journals An analysis of trends in maternal mortality at a tertiary care teaching hospital of Western Rajasthan, India: a four year retrospective study

2017 ◽  
Vol 4 (3) ◽  
pp. 864
Author(s):  
Neha Agrawal ◽  
Sandeep Kumar Uppadhaya ◽  
Afzal Hakim ◽  
Manish Mittal
Keyword(s):  
Maternal Mortality ◽  
Health Care Services ◽  
Economic Status ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Tertiary Hospital ◽  
College Hospital ◽  
Medical College ◽  
Care Services ◽  
Mortality Ratio

Background: Maternal mortality reflects not only the adequacy of health care services of any country or state but also the standard of living and socio-economic status of the community. India is among those countries, which has a very high maternal mortality ratio; the state of Rajasthan having the third highest maternal mortality in the country. This study was done to assess the maternal mortality in a tertiary hospital situated in Jodhpur, a city in Western Rajasthan where large numbers of patients are referred from rural parts in and around the city.Methods: This study was done to assess the trends in maternal mortality at a tertiary medical college hospital situated in Western Rajasthan. A retrospective hospital based study was carried out in the Obstetrics and Gynaecology Department of Ummaid hospital, Dr S. N. Medical College situated in Jodhpur, Rajasthan, India over a period of 4 years from July 2010 to June 2014.Results: During the study period spanning 4 years, there were in total 84,746 live births with 195 maternal deaths. The mean maternal mortality ratio for the four year period was found to be 230.1 per lakh live births.Conclusions: The maternal mortality was quite high than the national average.

Pattern of Provoking Factors and Psychiatric Co- morbidity in Migraine Headache: A Study from Tertiary Care Hospital

2018 ◽  
Vol 16 (1) ◽  
pp. 7-10
Author(s):  
Tanveer Ahmed Khan
Keyword(s):  
Anxiety Disorder ◽  
Migraine Headache ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Co Morbidity ◽  
The Common ◽  
The Mean

Introduction: Headaches are the most prevalent neurological disorders and among the most frequent symptoms seen in general practice among which migraine only accounts up to 30%. Certain factors are found to play role in the triggering of migraine headache. Avoidance of such factors is part of migraine management. Psychiatric co morbidities are common in migraine. Recognizing these co morbidities could therefore result in improved patient management. Methods: This study was done at Nepalgunj medical college hospital, Nepalgunj. Duration of study was six months i.e. from 1st July 2017 to 31st December 2017. All the new cases fulfilling diagnostic criteria of migraine headache visiting to psychiatric outpatient department were included in this study. The diagnosis of migraine was made based on criteria mentioned by the international classification of headache disorders (ICHD-II). Result: A total of 50 patients were enrolled in this study. The mean age of participants was 28.60 ± 10.388 years. There was significant predominance of female participants. Family history of migraine was found in 20 (40%) of participants. The mean age of onset was 22.76± 7.899 years. The commonest type of migraine was migraine without aura in 2/3rd number of cases. Psychiatric co-morbidity was found in 26 (52%) subjects among which the most common co-morbidity was anxiety disorder in 16 (32%) followed by depression in 8 (16%). Presence of provoking factors was found in 38 (76%) subjects. Light, smoke, smell, noise and lack of adequate sleep were the common provoking factors. Conclusion: Migraine predominantly affects females with common age of onset in second and third decade. Psychiatric co-morbidities are common in migraine patients. Anxiety disorder and depression are the commonest co-morbidities. The common provoking factors are light, smoke, smell, noise and lack of adequate sleep found in migraine. Avoidance of provoking factors and early detection and management of psychiatric co morbidities can result in better outcome.

scholarly journals Antimicrobial Resistance Pattern of Bacterial Isolates from Intensive Care Unit of a Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 8 (1) ◽  
pp. 7-11
Author(s):  
Taslima Akter ◽  
Mohammad Murshed ◽  
Taslima Begum ◽  
Kamrun Nahar ◽  
Syeda Sharmin Duza ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Care Hospital ◽  
College Hospital ◽  
Antibiotic Susceptibility Pattern ◽  
Medical College ◽  
Highly Active ◽  
The Common

Infections with resistant strain are one of the leading causes of morbidity and mortality in hospitalized patients especially the critically ill patients in intensive care unit (ICU). The present study was conducted to know the changing pattern of antibiotic resistance of the common isolates from blood, urine, respiratory secretions and pus/ wound swab of patients admitted in ICU at Holy Family Red Crescent Medical College hospital over a two years period from January 2012 to December 2013. A total of 1282 samples were analyzed. Out of which 301 (23.5%) samples were positive for growth of organisms. The predominant isolates were E.coli (28%), Klebsiella (27%), Acinetobacter (17.3%), Pseudomonas (9.6%), Staphylococcus aureus (5.3%) & candida (6%). Majority isolates were resistant to Cephalosporin and Amoxycillin, (>70-90%). Carbapenem were still highly active against E.coli. However, Klebsiella, Pseudomonas and Acinetobacter were showing alarming resistance (55-60%) towards those drugs. Aminoglycosides resistance has also increased for Pseudomonas and Klebsiella. The percentage of Cloxacillin resistant for staphylococcus was near about 40%. The most active drug against Pseudomonas was piperacillin/Tazobactam. The positive result from this study was that organisms showed decreased resistance towards Tetracycline, Cotrimoxazole and Ciprofloxacin. The sensitivity of Nitrofurantoin for urinary isolates was good. Regular surveillance of antibiotic susceptibility pattern & judicious use of antibiotics is very important for reducing the infection rate and antimicrobial resistance.Bangladesh J Med Microbiol 2014; 08 (01): 07-11

scholarly journals MATERNAL MORTALITY 2007-2008

2010 ◽  
Vol 17 (02) ◽  
pp. 291-294
Author(s):  
AISHA ABDULLAH SHAIKH ◽  
SADIA SABOOHI ◽  
RUBINA A D MEMON
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Case Series ◽  
Medical College Hospital ◽  
Contributing Factors ◽  
College Hospital ◽  
Maternal Deaths ◽  
Medical College ◽  
Case Series Study

Objectives: To analyse the maternal mortality with its causes and possible contributing risk factors at Ghulam Mohammad Mahar Medical College Hospital, Sukkur. Setting: This study was carried out at Gynae / Obs Unit-1 of Ghulam Mohammad Mahar Medical College Hospital, Sukkur from Jan-2007 to Dec-2008. Study Design: Descriptive case series study. Subjects and Methods: This study was conducted by analysing the death records of all maternal deaths who died over a period of two (02) years from Jan 2007 to Dec 2008. Thedemographic record included age, parity, booking status and education. The cause of death and possible contributing factors were evaluated. Results: 48 mothers died during this period making Maternal Mortality Ratio (MMR) of 1578/ 100,000 live births. Direct causes contributed to 79% (38) of maternal deaths while 21% (10) were due to indirect causes. The major causes of deaths were eclampsia 27% (13), haemorrhage33% (11), Sepsis 21% (10), Obstructed labour 8% (4). Among indirect causes, hepatic encethalopathy, anemia and renal failure were observed. Conclusions: Eclampsia, haemorrhage and Sepsis are still the major killers. Factors which need urgent improvement include education, antenatal booking, early diagnosis and referrals to tertiary care centers.

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