scholarly journals Clinical profile and outcome of neonates with congenital diaphragmatic hernia: A 16-year experience from a developing country

2018 ◽  
Vol 28 (1) ◽  
pp. 74-78
Author(s):  
Kamal Nain Rattan ◽  
Poonam Dalal ◽  
Jasbir Singh
Keyword(s):  
Birth Weight ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Health Workers ◽  
Heart Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Developed Countries ◽  
North India ◽  
Average Birth Weight

Recent advances in the perinatal interventions for neonates with congenital diaphragmatic hernia have remarkably improved the outcome in developed countries, but high mortality for such cases continues to be a challenge in resource-poor settings. This study examines clinical profiles and short-term outcome of neonates with congenital diaphragmatic hernia, using a retrospective analysis of medical records of neonates operated for congenital diaphragmatic hernia at a tertiary care center in North India from January 2001 to December 2016. Forty-two neonates were operated during the study period with male:female ratio = 1.6:1. Postoperative survival rate was 69% (29/42). Average birth weight in the survivors was 2528±267 g as compared with 2132±309 g in the non-survivors. The average gestational age in the two groups was 37.2±0.8 weeks and 34.8±1.8 weeks respectively. Twenty-one patients presented in the initial 48 h of life, out of them 52% (11/21) survived. Congenital heart diseases were associated with seven and malrotation of the gut in five neonates. The most significant factors resulting in the unfavorable outcome were preterm gestation, low birth weight, hypothermia and shock at presentation, the onset of symptoms <48 h of life, liver-up, need of postoperative inotropes and mechanical ventilation. In addition to establishing advanced therapeutic modalities, good antenatal screening, better awareness in peripheral health workers about the malformation leading to timely referral, well-equipped inter-hospital and intra-hospital transport facilities and development of level III neonatal intensive care units can improve survival in neonates with congenital diaphragmatic hernia in developing countries.

Survival of Premature Babies with the Revolutionary Kangaroo Mother Care Technique at a Tertiary Care Center, Sindh, Pakistan

2021 ◽  
Vol 15 (11) ◽  
pp. 3244-3246
Author(s):  
Bakhtiar Ahmed Bhambrho ◽  
Nisar Ahmed Shar ◽  
Amjad Ali Mughal ◽  
Farukh Imtiaz ◽  
Pardeep Kumar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Health Workers ◽  
Care Center ◽  
Tertiary Care ◽  
Scale Up ◽  
Sampling Technique ◽  
Kangaroo Mother Care ◽  
Primary Data ◽  
Resource Limited ◽  
Skin To Skin

Background: Kangaroo mother care (KMC) is a resource-limited method for low-birth-weight babies that seeks to mitigate mortality rates by thermoregulation, breastfeeding assistance, and early hospital discharge. Methods: This study was carried out at GIMS hospital Khairpur Kangaroo Mother Care Unit at PAQSJIMS between August 2019 to September 2020. A total of hundred mothers and their infants were enrolled in the study. A non-probability convenience sampling technique was employed. A Questionnaire filled with the permission of admitted mother and primary data collected as per proforma i.e. date of admission, mother name, address, age, parity, gravida, date of delivery, place of delivery, Type of delivery, gestation at birth (weeks), birth weight, gender, Date of KMS admission, weight at KMC, discharge date of KMC, weight of Discharge KMC, status at the time of discharge and cause of death (if any). All mothers used KMC kits and the infant weight at admission and discharge were documented. Results: The average age (Figure 1) of mothers was recorded as 31.69 (20-40 years). The babies weight at the time of KMC unit admission was recorded as 0.7 – 1.8 grams and after 3-4 weeks admission the babies survived and gained weight recorded at time of discharge was 0.8 to 2.2 grams which showed that all mothers used kits properly, and all babies survived. Conclusions: All mothers were pleased to operate KMC kits. KMC is a very innovative technique to save the lives of premature newborns. This therapy emphasizes mothers for continuous skin-to-skin touch with infants, as well as wrapping the child in a warm blanket. The availability of space facilities and capacity building for health workers are therefore the fundamental requirements that must be funded by international aid agencies in order to scale up the initiative in these environments. Keywords: Neonatal survival, KMC, care, breastfeeding.

Diagnostic challenges in late-presenting congenital diaphragmatic hernia: a 16-year experience from tertiary care centre in North India

2019 ◽  
Vol 49 (2) ◽  
pp. 138-141 ◽  
Author(s):  
Kamal Nain Rattan ◽  
Jasbir Singh ◽  
Poonam Dalal
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Tertiary Care ◽  
Therapeutic Interventions ◽  
North India ◽  
Ultrasound Screening ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Plain Chest Radiograph

With increasing use of ultrasound screening, the prenatal diagnosis of congenital diaphragmatic hernia (CDH) in better resourced areas has become the norm. However, early diagnosis is still not universal in resource-poor settings and late presentations of CDH continue. We retrospectively analysed the medical records of children operated for late-presenting CDH from 2001 to 2016 at our tertiary care centre in North India. A total of 32 patients were operated during the period with a male-to-female ratio of 3:1. Of these, 78% presented with respiratory symptoms, 37% with recurrent vomiting and 18% with an acute abdomen. Nine (28%) had been treated erroneously for gastroenteritis and another six (18%) had received anti-tubercular therapy for variable periods. A plain chest radiograph with a Ryle’s tube in situ was confirmatory in 75% (24/32). In conclusion, initial misdiagnosis and subsequent unnecessary therapeutic interventions were the leading cause of morbidity .

scholarly journals 59: Fetal endoscopic tracheal occlusion for severe isolated left-sided congenital diaphragmatic hernia: a USA tertiary care center experience

2016 ◽  
Vol 214 (1) ◽  
pp. S41
Author(s):  
Michael Belfort ◽  
Oluyinka O. Olutoye ◽  
Darrell L. Cass ◽  
Olutoyin A. Olutoye ◽  
Alireza A. Shamshiraz ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Tracheal Occlusion

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

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.

scholarly journals Vaginal deliveries in a tertiary centre: a current profile

2019 ◽  
Vol 9 (1) ◽  
pp. 134
Author(s):  
D. M. Christe ◽  
D. Tamilselvi ◽  
S. Surya ◽  
S. Shobha ◽  
C. Ponnuraja
Keyword(s):  
Birth Weight ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Births ◽  
Urban Background ◽  
Maternal Deaths ◽  
Normal Delivery ◽  
Average Birth Weight ◽  
Perinatal Deaths ◽  
Vaginal Deliveries

Background: A normal delivery is what every woman wishes to have. The objective of this study was to find out the maternal and neonatal outcome and background characteristics of women delivering vaginally in a tertiary care center in Chennai, South India.Methods: For this one-year study, with power above 80%, Parturition records were selected by computerized random numbers, for a calculated sample size. Salient demographic features such as age, residential background and religion were noted. Details of obstetric history, past and current, delivery and baby details and admission to NICU were analyzed. Acceptance of postpartum contraception was noted.Results: A total of 338 women delivered vaginally. Majority of 63%, were from urban background. Late referrals were 19.2% of women,38.5% women had antenatal complications. Primigravida were 49.7%. Nearly 91.4% of women delivered naturally. Previous pregnancy loss was noted in 14.8%. Term deliveries were in 72% of women, and 2.7% of women delivered twins. Average birth weight among primi was 2.5kg and in multi it was 2.8 kg. There were no maternal deaths. Perinatal deaths of 2.96%, of which 90% were preterm births, and all among babies with birth weight below 1.5 kg.Conclusions: The larger majority of 91.4% of women had natural vaginal delivery. Primigravida were 49.7%, and 63% were from urban background. Antenatal complications, obstetric, medical or other complications were noted in 38.5 % of women. Most often observed complications were Gestational hypertension, Gestational diabetes, and Hypothyroidism. NICU care was required for 18% of babies. Preterm births were16.6%. Perinatal deaths were seen in 2.96% of babies. There were no maternal deaths.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

Mothers of Infants With Congenital Diaphragmatic Hernia Describe “Breastfeeding” in the Neonatal Intensive Care Unit: “As Long as It’s My Milk, I’m Happy”

2017 ◽  
Vol 33 (3) ◽  
pp. 524-532 ◽  
Author(s):  
Elizabeth B. Froh ◽  
Janet A. Deatrick ◽  
Martha A. Q. Curley ◽  
Diane L. Spatz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Intensive Care ◽  
Safety Net ◽  
Prospective Longitudinal

Background: Very little is known about the breastfeeding experience of mothers of infants born with congenital anomalies and cared for in the neonatal intensive care unit (NICU). Often, studies related to breastfeeding and lactation in the NICU setting are focused on the mothers of late preterm, preterm, low-birth-weight, and very-low-birth-weight infants. Congenital diaphragmatic hernia (CDH) is an anatomic malformation of the diaphragm and affects 1 in every 2,000 to 4,000 live births. Currently, there are no studies examining the health outcomes of infants with CDH and the effect of human milk. Research aim: This study aimed to describe the breastfeeding experience of mothers of infants with CDH cared for in the NICU. Methods: A prospective, longitudinal qualitative descriptive design was used. Phased interviews were conducted with a purposive sample of 11 CDH infant–mother dyads from a level 3 NICU in a children’s hospital. Results: Six themes emerged from the data: (a) hopeful for breastfeeding, (b) latching on . . . to the pump, (c) we’ve already worked so hard, (d) getting the hang of it—it’s getting easier, (e) a good safety net, and (f) finding a way that works for us. Conclusion: For this population of CDH infant–mother dyads, the term breastfeeding is not exclusive to direct feeding at the breast and the mothers emphasized the significance of providing their own mother’s milk through a combination of feeding mechanisms to their infants with CDH.

Outcomes of radiocephalic fistula created by nephrologists

2019 ◽  
Vol 20 (6) ◽  
pp. 615-620
Author(s):  
Narayan Prasad ◽  
Venkatesh Thammishetti ◽  
DS Bhadauria ◽  
Anupama Kaul ◽  
RK Sharma ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Patency ◽  
North India ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Secondary Failure ◽  
Stage Renal Disease

Introduction: Arteriovenous fistula is considered as gold standard access for maintenance hemodialysis. Due to increasing burden of end-stage renal disease requiring dialysis, it is important for nephrologists to complement creation of arteriovenous fistula to meet the demand. Methods: This retrospective study was designed to assess the outcomes of arteriovenous fistula made by nephrologists at a tertiary care center from North India. The study included all radiocephalic arteriovenous fistula performed by nephrologists between November 2015 and January 2017. All arteriovenous fistulas were performed in patients whose duplex ultrasonography revealed both arterial and venous diameter of at least 2 mm. Data were collected with regard to age, gender, dialysis status, basic diseases, co-morbidities, and mineral bone disease parameters. The predictors of the primary and secondary patency rates were analyzed. Results: Five hundred patients (age 39.3 ± 14.4 years; 82.4% males; 21.6% diabetics) were included. In total, 83 (16.6%) patients had primary failure and 31 (7%) patients had secondary failure. Diabetes was associated with poor primary and secondary patency rates. Mean survival among the patients without primary failure was 11 months. The primary patency rates at 3, 6, 12, 18, and 21 months were 82%, 78%, 73%, 70%, and 70%, respectively. Conclusion: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes.

scholarly journals Effectiveness of Transjugular Intrahepatic Portosystemic Shunt in Variceal Bleeding: An Audit from a Tertiary Care Center in North India

2017 ◽  
Vol 01 (03) ◽  
pp. 150-155
Author(s):  
Arun Gupta ◽  
Ajay Mehta ◽  
Nitin Mishra ◽  
Rajendra Bansal ◽  
Ajit Yadav
Keyword(s):  
Variceal Bleeding ◽  
Patency Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Portosystemic Shunt ◽  
North India ◽  
Related Complication ◽  
Variceal Bleed ◽  
Intrahepatic Portosystemic Shunt

AbstractVariceal bleeding is one of the most feared complications of cirrhosis and portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective minimally invasive option to achieve adequate decompression of the portal system. The aim of the study was to assess the efficacy and complications of TIPS in patients presenting with variceal bleed. It was a retrospective study done in a tertiary care center in North India in cirrhotic patients with acute or recurrent variceal bleed who underwent TIPS from April 2010 to October 2013. All the patients were followed up till April 2014. We could successfully implant TIPS in 100% of our patients with 100% success rate in controlling variceal bleeding immediately and during the follow-up period. Our primary patency rate was 94.5% and overall patency rate was 100%. Major TIPS-related complication was hepatic encephalopathy in 20% of patients; 7 of 22 patients died during the follow-up period. TIPS is a safe and effective procedure for control of acute or recurrent variceal bleed. Emerging evidence in favor of early TIPS is further going to expand its indication in variceal bleed. Hepatic encephalopathy was the major procedure-related complication in our study consistent with previous literature reports.

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