A RETROSPECTIVE STUDY OF OBSTETRICAL OUTCOME IN ART AND SPONTANEOUS PREGNANCIES.

2019 ◽  
Vol 9 (9) ◽  
pp. 614-621
Author(s):  
Manisha Shrivastava*, Bhanwar Singh Meena

Background: Infertility tends to be one of the emerging health concern withtoday’s world .It is a common condition affecting approx 8-9% ofreproductive age group. Infertility diagnosis is divided into etiologies ofovulatory dysfunction, tubal endometriosis, and uterine, unexplained andmale factors. Certain type of infertility such as severe male factors andcomplete tubal obstruction will require ART.Objective:To study obstetrical outcome in pregnancy conceived with assistedreproductive techniques .Materials and Methods: A Retrospective study was done and data wascollected of patients, who have conceived through assisted reproductivetechniques admitted and delivered at tertiary care hospital from January2017 to June 2017.Results: They were anaemia 25(24.27%) and 17(16.19%) in ART andspontaneous conception respectively (p- value<0.147), hypothyroid40(38.83%) and 14(13.33%) in ART and spontaneous conception respectively(p- value<0.0001, highly significant), chronic hypertension 27(26.21%) and4(3.81%) in ART and spontaneous conception respectively (p- value<0.0001,highly significant), DM Type-2 10(9.71%) and 0(0.00%) in ART andspontaneous conception respectively (p- value<0.280, not significant). Studyalso showed that various obstetrical complications common in ART group.They were preterm birth, PIH, Polyhydramnios, Placenta previa, APH,Oligohydromnios, PPROM, GDM, Multiple pregnancies.Conclusion: There was a significant association between obstetricalcomplications with age. Maternal pre-existing disease like anaemia, chronichypertension, hypothyroidism and diabetes mellitus should be treated beforeconception, to improve maternal and perinatal outcome.Keywords: Assisted reproductive technology, SpontaneousConception,Pregnancy.

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110529
Author(s):  
Mamdouh Qadi ◽  
Mohammed Hasosah ◽  
Anas Alamoudi ◽  
Abdullah AlMansour ◽  
Mohammed Alghamdi ◽  
...  

Background. Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic relapsing disease indicated by inflammation of the gastrointestinal tract. Celiac disease (CeD) is a chronic autoimmune disease of the small bowel. The prevalence of CeD in IBD patients is unknown. Some studies have described the coexistence of the 2 diseases in the same patient. This study aimed to investigate the prevalence of CeD in Saudi Arabian children with IBD. Methods. We used a retrospective study design because data can be collected immediately and is easier to analyze afterward. The study was conducted on IBD patients in the Pediatric Gastroenterology Department at National Guard Hospital, Jeddah, Saudi Arabia. We enrolled Saudi patients aged between 1 and 18 years who had been diagnosed with IBD and CeD based on positive biochemical serology and histology from January 2011 to January 2020. We excluded patients with immunodeficiency disorders. Results. Among the 46 enrolled patients with IBD, CeD was identified in 4, and they did not develop any relapses. We discovered that the weight at IBD diagnosis improved significantly compared to current weight ( P-value < .0001). We also discovered that the height at diagnosis of IBD improved significantly compared to the current height ( P-value < .0001). Additionally, we found no significant associations between UC and CeD ( P-value = 1), or CD and CeD ( P-value = .625). Conclusion. No significant associations were evident between the prevalence of CeD and IBD. More prospective multicenter studies are needed to clarify the prevalence of CeD in children with IBD.


Author(s):  
Jyothi Susan Thomas ◽  
Mary Daniel ◽  
Sangeetha Selvaraj

Background: Amniotic fluid provides a protective milieu for the growing fetus in pregnancy and labour. A decrease in the amniotic fluid volume has been associated with increased maternal morbidity and fetal morbidity and mortality. The purpose was to compare the effect of labour induction on the fetomaternal outcome in women with oligohydramnios, borderline liquor and normal liquor at term.Methods: A retrospective study of all the labour induction in women with oligohydramnios, borderline liquor and normal liquor volume at 37-42 weeks gestation in a tertiary care teaching hospital. The demographic characteristics, maternal outcomes like mode of delivery, indication for operative delivery, meconium stained liquor and perinatal outcomes were compared in between the three groups. Parametric data was compared by chi-square test and non-parametric data by students’-test. A p-value less than 0.05 was taken as significant.Results: Among the 2338 deliveries during the study period, labour was induced in 266 women (11.3%). Out of which, 109 cases (40.9%) in oligohydramnios group, 111cases (41.7%) in borderline liquor group and 46 cases in normal liquor group. The incidence of meconium stained liquor, the number of operative deliveries and fetal distress was significantly higher and significantly lower birth weight (<2.5 kg) in the group with oligohydramnios and borderline liquor (p <0.05). Low Apgar score and admission to neonatal intensive care unit was higher in the oligohydramnios group (p<0.05).Conclusions: Induction of labour on detecting borderline liquor at term may help in reduction of maternal and fetal morbidity and mortality.


Author(s):  
Anna Joy ◽  
Aparna Anand ◽  
Arathy R Nath ◽  
Meera S Nair ◽  
Dr. K. G. Prasanth

Antibiotics are one of the most commonly prescribed drugs today. Rational use of antibiotics is therefore extremely important as their injudicious use can adversely affect the patient. Drug Utilization Evaluation (DUE) is a system of ongoing systematic criteria based evaluation of drug that will help to ensure that medicines are used appropriately. It is drug/disease specific and can be structured so that it will assess the actual process of prescribing, dispensing, or administration of drug. The retrospective study was conducted At Pk Das Institute of Medical Sciences, Palakkad, Kerala for a duration of 6 months (February 2017 - January 2018). A source of data includes Patient case sheets &medication charts, nursing charts, culture & sensitivity reports. The inclusion criterion includes Patients aged between 18- 80 year, prescribed with oral and parenteral antibiotics. . On analyzing the gender, male gender (n= 111, 55.5%) were higher in numbers as compared to female counterparts (n=89, 44.5%). In our study the majority of the patients prescribed with antibiotics were with the clinical assessment of COPD (n=39, 19.5%), UTI (n=37, 18.5%) and LRTI (n=28, 14%), Bronchial asthma (n=19, 9.5%) respectively. On analyzing the data based on antibiotic sensitivity test, antibiotic test were performed and followed in (n=64,32%)prescriptions and in (n=47,23.5%)prescriptions were test is not followed respectively. In (n=89,44.5%) prescriptions, antibiotic sensitivity test is not performed. On analysis of antibiotics prescribed, the most commonly prescribed antibiotics were cephalosporins, of these ceftriaxone was highly prescribed of all (n=95). The high percentage of antibiotic prescriptions may indicate a high probability of irrational use. This study also point out irrational use of antibiotics are more leading to resistance, misuse and serious problems. So certain strategies should be put forward to strengthen rational use of antibiotics. Keywords: Antibiotics, Antibiotic Susceptibility Test, Irrational use, Resistance


2019 ◽  
Vol V-5 (I-1) ◽  
pp. 1-5
Author(s):  
Babu Janarthan ◽  
Krishna Nikhil ◽  
Dattatreya P.S. ◽  
Nirni S.S. ◽  
Vasini Vindhya

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.


2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)


Author(s):  
Fahima Hossain ◽  
Mohammad Delwer Hossain Hawlader ◽  
Dipak Kumar Mitra ◽  
Mohammad Hayatun Nabi ◽  
Md. Mujibur Rahman

Abstract Background Neuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions. Results A total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud’s phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations. Conclusion NP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted.


Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.


2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27


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