Neonatal Outcomes of Pregnant Women With Confirmed Coronavirus Disease 2019: One-Year Experience of a Tertiary Care Center

The coronavirus disease 2019 (COVID-19) pandemic became an important public health problem affecting all age groups. The aim of this study was to evaluate clinical and laboratory findings of newborns born to mothers with COVID-19. Thirty pregnant women with COVID-19 were admitted to Turgut Ozal University Hospital for delivery. Fourteen pregnant women had at least one symptom associated with COVID-19. Positive polymerase chain reaction (PCR) results were seen in only 3 (9.7%) of 31 newborns. A statistically significant difference was observed between PCR-positive and PCR-negative newborns in terms of any adverse pregnancy outcomes. Neonatal lymphocyte count and partial arterial oxygen pressure were significantly lower in the PCR-positive group. Results were also compared according to the interval from the maternal diagnosis time to delivery. Hemoglobin and hematocrit levels in newborns born to mothers diagnosed more than 7 days before delivery were significantly lower. Neonates born to mothers with COVID-19 had mild clinical symptoms and favorable outcomes.

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Incidence of anemia in pregnancy and its maternal-fetal outcome in admitted ANC patients in tertiary care center, Bhilai, Chhattisgarh, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211112 ◽

2021 ◽

Vol 10 (4) ◽

pp. 1411

Author(s):

Geetanjali Kanwar ◽

Shweta Rani Prasad ◽

Rekha Ratnani

Keyword(s):

Pregnant Women ◽

Care Center ◽

Tertiary Care ◽

Public Health Problem ◽

Fetal Outcome ◽

Maternal Outcome ◽

Premature Delivery ◽

Important Public Health Problem ◽

Anemia In Pregnancy ◽

In Pregnancy

Background: Anemia in pregnancy is an important public health problem in developing countries like India. Anemia results in poor pregnancy outcome and also affects fetal outcome. The present study was conducted to asses maternal and fetal outcome in relation anemia. Aim and objectives of the study was to determine incidence, risk factors and maternal-fetal outcome of anemia in the admitted pregnant women attending obstetrics and gyanecology department, shanakarcharya institute of medical sciences, Bhilai.Methods: This is retrospective observational study conducted among pregnant women admitted in labor room over a period of one year after getting approval from the institutional ethical committee.Results: Out of total 1503 delivery during study period 675 patients were found to be anaemic which gives incidence of 44.5%. Most the pregnant women were moderately anaemic i.e. 50.96% followed by mild (45.04%) and severe (4%) repectively. Among the pregnant women most common type of anaemia is Iron deficiency anaemia (69.65%) followed by Sickle cell anaemia (15.4%). In the present study,90.4% of subject received oral iron, 26.9% received parenteral iron and 19.4% received blood transfusion. Common maternal outcome related to anemia found to be low birth weight (25.2%) followed by premature delivery (22.96%) and fetal outcome in anemic mother in the form of preterm (22.9%) followed by NICU admission (14.37%) and FGR (8.6%).Conclusions: Anemia being one of the most important cause of poor feto maternal outcome should be treated preconceptionaly. There is a need of health education programmes and adequate intake of iron rich diet during pregnancy, to be strengthened for safe maternal and foetal outcomes.

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PATTERN OF CANCER CASES REGISTERED IN A TERTIARY CARE CENTER IN KATHUA DISTRICT OF J&K: A CROSS SECTIONAL STUDY

10.36106/ijsr/0400712 ◽

2020 ◽

pp. 1-2

Author(s):

Deepak Abrol ◽

Anuj Kapoor ◽

Pawan Kumar

Keyword(s):

Care Center ◽

Tertiary Care ◽

Public Health Problem ◽

Cross Sectional Study ◽

Age Group ◽

Important Public Health Problem ◽

Cross Sectional ◽

Medical College ◽

Area Distribution ◽

The Government

Introduction:Cancer is an important public health problem in India, with 10 lakh new cases occurring every year in the year. Cancer pattern varies in different regions and depends on genetic, environmental, dietary, social and other factors. Aim and objectives: This study was undertaken to determine magnitude and pattern of cancer cases reporting in the hospital. Methodology: This was a hospital-based retrospective study undertaken in the Government Medical College Kathua. GMC, Kathua is one among st the ve new medical colleges established in Jammu & Kashmir. The records of cancer patients generated from 1st November 2018 to 1 November 2019 were analyzed. All the cancer cases who reported either for diagnosis in any of the hospital OPD or for the treatment (radiotherapy/ chemotherapy/ surgery) were included. Data was entered in the MS Excel for analysis Results: Out of total 272 patients registered, females accounted for 56.6% and males for 43.3%. Hindu patients were in majority (84.2%). Most of the cases (37.1%) were in the age group 60-80. Pattern of cancer was different in the two sexes. In males, maximum cases were of lung cancer and in females, Ca breast was the most common followed by the cervical cancer Conclusion: This hospital-based study indicates the cancer prole in Kathua district. Females were found to be more affected than that of males with majority of the cases in the late 40s age group. Rural area and urban area distribution was found to be almost similar.

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Anaphylaxis in Omani Patients: A Study from a Tertiary Care Center

Oman Medical Journal ◽

10.5001/omj.2021.113 ◽

2021 ◽

Author(s):

Salem Al Tamemi ◽

Yusra Al Lamki ◽

Shafiq Ur-Rehman Naseem ◽

Nabila Al Siyabi ◽

Bushra Al Siyabi ◽

...

Keyword(s):

Clinical Features ◽

Allergic Disease ◽

Clinical Symptoms ◽

Care Center ◽

Tertiary Care ◽

University Hospital ◽

Tertiary Care Center ◽

Total Ige ◽

Sultan Qaboos University ◽

True Incidence

Objective: Anaphylaxis is an acute and potentially fatal allergic reaction. To the best of the author’s knowledge, no studies have yet been conducted to evaluate the spectrum of anaphylactic reactions among Omani patients. As such, this study aimed to describe the clinical features, causes, investigation, and management of anaphylaxis among patients presenting to a tertiary care center in Oman. Methods: This retrospective study took place between August 2005 and June 2020 at the allergy and immunology clinic of the Sultan Qaboos University Hospital, Muscat, Oman. All patients diagnosed with anaphylaxis during the study period were included. Data were collected from electronic medical records. Results: A total of 100 patients were diagnosed with anaphylaxis during the study period. Of these, 52% were male. The mean age was 15.9  16.2 years, with 70% being <18 years old. The eosinophil count ranged from 0–16.9 ×109 /L, with a mean of 0.8  2.2 ×109 /L and a median 2 of 0.30 (IQR: 0.15-0.65) ×109 /L. Total IgE levels ranged from 25–8,706 kIU/L, with a mean of 935.1  1369.5 kIU/L and a median of 500.4 (IQR: 186.0-972.5) kIU/L. Overall, the majority of patients had a family history of allergies (72%), other concomitant allergic condition (66%) and were all prescribed epinephrine (100%). The most common cause of anaphylaxis was food (65%), the second most frequent trigger was insect venom (32%). The majority of patients had one category cause (81%) however two or more causes were present in 19% of the patients. Clinical symptoms manifested most frequently as cutaneous (92%), and respiratory (85%). The majority of patients (87%) demonstrated involvement of more than one bodily system. Total IgE levels were significantly higher in patients with concomitant presence of other allergic conditions 1193.8 kIU/L compared to patients without another concomitant allergic disease mean 503.6 kIU/L (p=0.03). In addition, concomitant other allergic disease is significantly higher in patients <18 years of age 75.4% compared to patients >18 years of age 45.2% (p= 0.01). Conclusions: Due to its life-threatening nature, knowledge of the epidemiology and clinical features of anaphylaxis in different populations is necessary in order to deliver rapid treatment. This study found that the clinical features of anaphylactic patients in Oman were similar to those reported elsewhere. Further research is needed to determine the true incidence of anaphylaxis in Oman in order to minimize associated morbidity and mortality.

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Prevalence, Risk Factors and Awareness about HCV Infection in Pregnant Women in a Tertiary Care Center in North India

Global Journal of Medical Research ◽

10.34257/gjmrevol20is1pg25 ◽

2020 ◽

pp. 25-29

Author(s):

Dr. Renu Gupta ◽

Dr. Rashmi Kumari ◽

Dr. Shaily Agarwal ◽

Dr. Kiran Pandey ◽

Dr. Neena Gupta ◽

...

Keyword(s):

Hepatitis C ◽

Pregnant Women ◽

Viral Infections ◽

Care Center ◽

Tertiary Care ◽

Public Health Problem ◽

Developed Countries ◽

North India ◽

Global Public Health ◽

Female Population

Among the viral infections affecting the liver in pregnancy, Hepatitis C though uncommon now is recognized to be a serious global public health problem affecting 170 million people worldwide I .e. 3% of the population [1]. The prevalence of anti-HCV antibody in pregnant women in developed countries ranges from 0.14 to 4.4%, whereas the seroprevalence in Indian pregnant female population is 1.03% [2,3,4].Following the decreasing transmission of HCV by blood -transfusion, intravenous drug use has now become the primary route of new HCV infections in adults while mother to child transmission (MTCT) is the major route of new infections in young children in the developed as well as in developing countries.[5]Approximately 7–8% of hepatitis C virus-positive women transmit this virus to their offspring [6]mainly because they are ignorant about this infection and unaware of their status. The natural course of hepatitis C is a progression from acute hepatitis to chronic hepatitis, which occurs in 55%-85 % of patients.

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Obstetric Outcomes of Teenage Pregnancies: A Hospital-based Study in a Tertiary Care Center

Medical Journal of Pokhara Academy of Health Sciences ◽

10.3126/mjpahs.v1i1.22458 ◽

2018 ◽

Vol 1 (1) ◽

pp. 35-40

Author(s):

Dela Singh ◽

Rabi Regmi ◽

Tara Gurung ◽

Lakshmi Sunar

Keyword(s):

Teenage Pregnancy ◽

Statistical Significance ◽

Care Center ◽

Tertiary Care ◽

Public Health Problem ◽

Intrauterine Fetal Death ◽

Obstetric Outcomes ◽

Vaginal Deliveries ◽

Significant Difference ◽

Nicu Admission

Background: Teenage pregnancy is a pregnancy in a woman of age group 10-19 years which is a worldwide public health problem in both developed and developing countries. Pregnancy during this period is usually unplanned and is associated with increase maternal and perinatal morbidity and mortality. The overall aim is to study the obstetric outcome in teenage pregnancy and comparing them with the adult group. Materials and methods: A hospital-based study was conducted among teenager primiparous women aged 13-19 years while comparing them with 20-24 years primiparous delivering in the department of obstetrics and gynaecology in Pokhara, Nepal from July 20, 2017 to November 12, 2017. Medical details of the patients were retrospectively collected from the medical record section and used to record sociodemographic features, mode of deliveries, and gestational age at delivery, fetal and maternal outcomes on a structured observational checklist. Results: The incidence of teenage pregnancy was 11.22%. The mean age of teenager and control groups were 18.17± 0.86 and 22.13± 1.61 years respectively. The incidence of teenage pregnancy was higher in Dalits. Literacy was another factor that made a significant difference. The study group in comparision with the control had more vaginal delivery without episiotomy and less cesarean delivery. But there was no statistical significance in the incidence of instrumental delivery. The incidence of live birth, intrauterine fetal death, neonatal death and NICU admission had no statistical significance. Conclusion: Teenage pregnancy had more vaginal deliveries and less cesarean sections. Teenage pregnancy is not associated with adverse maternal and fetal outcomes.

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Post-Stroke Depression and Its Effect on Functional Outcomes during Inpatient Rehabilitation

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1731958 ◽

2021 ◽

Author(s):

Gurumayum Sonachand Sharma ◽

Anupam Gupta ◽

Meeka Khanna ◽

Naveen Bangarpet Prakash

Keyword(s):

Outcome Measures ◽

Functional Outcomes ◽

Rating Scale ◽

Tertiary Care ◽

Depression Scale ◽

Inpatient Rehabilitation ◽

University Hospital ◽

Post Stroke ◽

Significant Difference ◽

Post Stroke Depression

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.

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Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection

Otolaryngology ◽

10.1177/01945998211008915 ◽

2021 ◽

pp. 019459982110089

Author(s):

Quinn Dunlap ◽

James Reed Gardner ◽

Amanda Ederle ◽

Deanne King ◽

Maya Merriweather ◽

...

Keyword(s):

Neck Dissection ◽

Surgical Complications ◽

Chart Review ◽

Care Center ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Neck Surgery ◽

Continuous Variables ◽

Significant Difference ◽

History Of

Objective Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND). Study Design Retrospective chart review. Setting Academic tertiary care center. Methods Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05. Results Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P < .001) and endocrine pathology (34% vs 2.6%, P < .001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis. Conclusion While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.

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Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03525-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chitkasaem Suwanrath ◽

Sopen Chunuan ◽

Phawat Matemanosak ◽

Sutham Pinjaroen

Keyword(s):

Qualitative Study ◽

Pregnant Women ◽

Risk Perceptions ◽

Care Center ◽

Tertiary Care ◽

Cesarean Birth ◽

Positive Attitudes ◽

Cesarean Births ◽

Medical Indications ◽

Superstitious Beliefs

Abstract Background Increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications. Methods A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis. Results Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth in order to prevent or diminish unnecessary cesarean births.

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Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000297 ◽

2021 ◽

pp. 1-4

Author(s):

Ruo S. Chen ◽

Laurel O’Connor ◽

Matthew R. Rebesco ◽

Kara L. LaBarge ◽

Edgar J. Remotti ◽

...

Keyword(s):

Endotracheal Tube ◽

Cuff Pressure ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Endotracheal Tube Cuff ◽

Cross Sectional ◽

Tube Cuff ◽

Respiratory Therapists ◽

Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

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Evaluation of the Anxiety Level of Mothers of Children with Epilepsy during the COVID-19 Pandemic Period

European Neurology ◽

10.1159/000514826 ◽

2021 ◽

pp. 1-8

Author(s):

Halil Celik ◽

Sadettin Burak Acikel ◽

Fatih Mehmet Akif Ozdemir ◽

Erhan Aksoy ◽

Ulkuhan Oztoprak ◽

...

Keyword(s):

Neurological Disease ◽

Chronic Conditions ◽

Care Center ◽

Tertiary Care ◽

Anxiety Level ◽

Childhood And Adolescence ◽

Routine Examination ◽

Significant Difference ◽

Anxiety Levels

Background and Aim: Although anyone can be affected by the COVID-19 pandemic, it may cause additional concern for people with chronic conditions. Epilepsy is the most common neurological disease in childhood and adolescence. The aim of this study was to determine anxiety levels among the mothers of children under follow-up for epilepsy in our clinic during the COVID-19 pandemic. Methods: The study group consisted of the mothers of epilepsy patients who were under follow-up in the pediatric neurology outpatient clinic of the tertiary care center and were scheduled for a routine examination during the COVID-19 pandemic. The mothers’ anxiety levels according to the Beck Anxiety Inventory and their opinions about COVID-19 in relation to their child were assessed and compared based on whether the mother/patient attended their appointments in person and whether the child had frequent or infrequent seizures. Results: There was no statistically significant difference in anxiety level between the mothers of 64 children with epilepsy who attended their appointment during the pandemic and those of the mothers of 52 who did not attend their appointment. However, the mothers of children with frequent seizures had significantly higher anxiety levels. Conclusion: Anxiety level of mothers whose children have frequent seizures was significantly higher compared to mothers whose children have infrequent seizures. It is important to be aware about this point and using telemedicine approach in suitable population and postpone routine outpatient follow-up appointments as much as possible.

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