scholarly journals A study of visceral adiposity index as a diagnostic index in gestational diabetes mellitus in a tertiary care centre

2017 ◽  
Vol 6 (4) ◽  
pp. 1561
Author(s):  
Padmalatha Dakshnamurthy ◽  
Shaanthy Gunasingh Thangiah Kasirajan ◽  
Indhumathi Nachiyar ◽  
Mangala Geetha ◽  
Kannan Rajendran
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Visceral Adiposity ◽  
P Value ◽  
Visceral Adiposity Index ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Adiposity Index ◽  
The Mean ◽  
Diagnostic Index

Background: Gestational Diabetes Mellitus is an emerging problem which affects pregnant women all over the world particularly in India. Early detection reduces adverse maternal and foetal outcome. Elevated central adiposity is a modifiable risk factor for abnormal glucose homeostasis in pregnancy and GDM. The Visceral Adiposity Index (VAI) is a gender-specific index of fat distribution and assessment.Methods: It is a hospital based, case control study among the subjects who attended a tertiary care centre. cases were 30 pregnant women newly diagnosed with GDM in their 2nd trimester, and Controls were 30 apparently healthy pregnant women in their 2nd trimester without risk factors for GDM such as obesity and family history for diabetes. Visceral Adiposity Index (VAI) was calculated using the formula (Waist circumference (WC)/ {36.58 +(1.89xBMI)}) x(TGL/0.81) x (1.52/HDL) where WC is expressed in cm, BMI in Kg/m2, TG in mmol/L, HDL in mmol/L.Results: The mean age of patients with GDM was higher when compared to controls (28.17 ± 3.34vs 24.40±3.07) and this difference was statistically significant (p value < 0.0001). The average weights were significantly different. The mean Body Mass Index (BMI) and waist circumference (WC) was 23.59 ± 4.19 and 88.46 ± 7.10 respectively among controls and 29.85 ±4.52 and 102.12 ± 6.96 respectively among GDM patients and these differences were highly significant (p value<0.0001). The lipid profile of these patients showed a significantly higher value of Triglycerides among patients.Conclusions: This study correlates GDM with Visceral adiposity index and found that the index to be elevated in the GDM group. The increased VAI in GDM patients shows their elevated adipose tissue distribution.  VAI is less invasive and cost effective, can be used as a diagnostic index in GDM.

scholarly journals Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2395
Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Tertiary Care ◽  
Comparative Assessment ◽  
P Value ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Twin Pregnancies

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

scholarly journals Response of leuprolide on gonadal functions of women with overt hypothyroidism: a tertiary care centre study from Uttar Pradesh - India

2019 ◽  
Vol 8 (1) ◽  
pp. 277
Author(s):  
Manish Srivastav ◽  
Alankar Tiwari ◽  
Nihit Kharkwal ◽  
Keshav Kumar Gupta
Keyword(s):  
Human Subject ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Ovarian Response ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Newly Diagnosed ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Healthy Females

Background: Hypothyroidism can cause menstrual disturbances mainly oligoanovualtory cycles and sometimes menorrhagia. It has also been seen to cause subfertility and pregnancy related complications. Various studies have been done to evaluate gonadal dysfunctions in overt hypothyroidism but very few studies are there which have done using a gonadotrophin response in that subset of patients. Present study evaluates the response of leuprolide on gonadal functions of women with overt hypothyroidism in a tertiary care centre at Meerut.Methods: In this study 50 females of age 20 to 40 years with newly diagnosed overt hypothyroidism were taken as cases and age and Body Mass Index (BMI) matched healthy females were taken as controls. Both in cases and controls, basal FSH, LH, estradiol was measured on 2nd day to 5th day of menstrual cycle. Thereafter Leuprolide 20 mcg/kg was given subcutaneously on the same day. Post leuprolide test, stimulated LH, FSH and estradiol were measured. Basal and stimulated values were compared between both groups.Results: Basal LH was significantly higher in controls (8.2±3.2 mIU/L) when compared to cases (6.45±2.75 mIU/L) with a p value 0.03(<0.05). Basal estradiol and FSH levels were found to be nearly similar and non-significant in cases and controls. No significant differences were found between stimulated mean LH and estradiol in both the groups. Leuprolide response after stimulation test was found to be sluggish in patients with overt hypothyroidism compared to normal euthyroid controls. This study is the rare one done on human subject in tertiary care centre of India, however large sample and multicentric trials are necessary before establishing the biochemical results.Conclusions: Pituitary and gonadal (ovarian) response to leuprolide was found to have impaired (decreased) in overt hypothyroidism cases. This is the first study to be done in overt hypothyroid subjects to asses both basal and stimulated gonadotropin levels.

scholarly journals OPTIONAL VACCINE UTILIZATION HAS A MALE GENDER PREFERENCE – A RECORD BASED ANALYSIS FROM A TERTIARY CARE CENTRE OF EASTERN INDIA

2020 ◽  
Author(s):  
Sandeep Kumar Panigrahi ◽  
Anumita Maiti ◽  
Venkatarao Epari
Keyword(s):  
Hepatitis A ◽  
Tertiary Care ◽  
Secondary Data ◽  
Gender Disparity ◽  
Measles Vaccine ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Important Place ◽  
Universal Immunization Program ◽  
The Mean

Background And Objectives: Optional vaccines find an important place in immunization today. This study attempts to find out the trend of optional vaccine utilization, over the past three years in the immunization clinic of a tertiary care centre and to find out the association of gender disparity with the utilization of these vaccines. Methods: The retrospective study was conducted during October to December 2016 using the register based secondary data of October 2013 to September 2016. Month wise utilization of optional vaccines (Pneumococcal, influenza, typhoid, varicella, hepatitis A and MMR) and measles was captured. Analysis was done using Stata 12.1 SE. Results: An increasing trend of utilization was seen for all vaccines including optional vaccines. The mean doses received by male children was significantly more for all optional vaccines (unlike all vaccines taken together) as well as for individual vaccines like Pneumococcal, influenza, typhoid, MMR, hepatitis A (p<0.05), but not for varicella and measles vaccine (p>0.05). Conclusion: Gender disparity (preference for male children) was present for all optional vaccines except varicella, and not in case of measles vaccine used in universal immunization program selected as control.

scholarly journals Experience of managing first fifty COVID-19 positive peripartum women in a tertiary care centre in North India

2021 ◽  
Vol 10 (3) ◽  
pp. 1036
Author(s):  
Vijay Zutshi ◽  
Neha Mohit Bhagwati ◽  
Alka .
Keyword(s):  
Pregnant Women ◽  
Severe Disease ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
North India ◽  
Tertiary Care Centre ◽  
Mild Disease ◽  
Qrt Pcr ◽  
The Mean

Background: SARS-CoV-2 has caused significant morbidity and mortality worldwide. Analysis of the clinical profile of COVID-19 positive pregnant women is important to understand the pathophysiology, transmission and outcome of the disease in Indian population.Methods: It is a retrospective observational study of first fifty pregnant patients tested positive for COVID-19 by qRT PCR admitted for delivery in our hospital.Results: In this audit, first fifty COVID-19 pregnant women were studied and the mean age of the patients in this study was 26 years. 98% of these women were admitted for obstetric indications. Seventy two percent of these women were admitted with spontaneous onset of labour. Based on disease severity, 49 (98%) were either asymptomatic or exhibited mild disease and only 1 (2%) had severe disease who succumbed to her illness. Forty six percent patients delivered vaginally and 54% required cesarean delivery. The most common indication for LSCS was fetal distress (43%). Eighteen percent had preterm delivery. Among the newborn babies, one died due to severe birth asphyxia. Sixteen percent babies required NICU stay. Five babies tested positive for COVID-19 of which one baby was positive on day one of life.Conclusions: As per our results, majority of the COVID-19 positive pregnant women had mild disease. There has been increase in cesarean section rate as compared to the previous hospital figures. Only one baby tested positive within 24 hours of delivery so the possibility vertical transmission can not be commented upon as of today.

scholarly journals Study of magnitude of anaemic problem in rural tertiary care centre in outpatient department

2018 ◽  
Vol 6 (11) ◽  
pp. 3499
Author(s):  
Anjaneya Prasad V. ◽  
Anjani Kumar C. ◽  
Neelima V. ◽  
Sai Prasanth R.
Keyword(s):  
Public Health ◽  
Low Cost ◽  
Tertiary Care ◽  
Outpatient Department ◽  
P Value ◽  
Cost Ratio ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Major Health Problem

Background: Prevalence of anaemia is very high in rural tertiary care hospital O.P.D patients. Anemia is the most common morbidity among micronutrients and affects health, education, economy, and productivity of the entire nation. Anemia, like fever, is a manifestation and not a disease per se. The most common group among the causes for anemia is malnutrition and among that group, iron deficiency makes up the bulk of it. Girls are more likely to be a victim due to various reasons. In a family with limited resources, the female child is more likely to be neglected. She is deprived of good food and education and is utilized as an extra working hand to carry out the household chores. The added burden of menstrual blood loss, normal or abnormal, precipitates the crises too often. Anemia can usually be prevented at a low cost, and the benefit/cost ratio of implementing preventive programs is recognized as one of the highest in the realm of public health. This information has equipped everyone in public health to take action against this long-standing problem and to do whatever is needed to be done.Methods: In our study 200 people attending medical outpatient department at a tertiary care centre were enrolled. Assessment of the anaemic problem is worked out.Results: Out of 200 patients, 107 were females and 93 were males. 49 females out of 107 had haemoglobin less than 10 and 9 males out of 93 are having haemoglobin less than 10. Among people with hemoglobin less than 10, 84.5% are females. Significant p value was observed in females (<0.0001).Conclusions:Anemia continues to be a major health problem in developing countries like India, particularly rural India. Despite different strategies and programs have been taken by government of India the growing menace of anaemia is not solved. So newer strategies must be taken.Background: Prevalence of anaemia is very high in rural tertiary care hospital O.P.D patients. Anemia is the most common morbidity among micronutrients and affects health, education, economy, and productivity of the entire nation. Anemia, like fever, is a manifestation and not a disease per se. The most common group among the causes for anemia is malnutrition and among that group, iron deficiency makes up the bulk of it. Girls are more likely to be a victim due to various reasons. In a family with limited resources, the female child is more likely to be neglected. She is deprived of good food and education and is utilized as an extra working hand to carry out the household chores. The added burden of menstrual blood loss, normal or abnormal, precipitates the crises too often. Anemia can usually be prevented at a low cost, and the benefit/cost ratio of implementing preventive programs is recognized as one of the highest in the realm of public health. This information has equipped everyone in public health to take action against this long-standing problem and to do whatever is needed to be done.Methods: In our study 200 people attending medical outpatient department at a tertiary care centre were enrolled. Assessment of the anaemic problem is worked out.Results: Out of 200 patients, 107 were females and 93 were males. 49 females out of 107 had haemoglobin less than 10 and 9 males out of 93 are having haemoglobin less than 10. Among people with hemoglobin less than 10, 84.5% are females. Significant p value was observed in females (<0.0001).Conclusions: Anemia continues to be a major health problem in developing countries like India, particularly rural India. Despite different strategies and programs have been taken by government of India the growing menace of anaemia is not solved. So newer strategies must be taken.

scholarly journals Impact of COVID-19 on the patient visits in ortho emergency at a tertiary care centre

2020 ◽  
Vol 9 (1) ◽  
pp. 192
Author(s):  
Nitin Choudhary ◽  
Akhil Gupta ◽  
Sanjeev Gupta ◽  
Amar Saharan
Keyword(s):  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Patient Awareness ◽  
Notable Effect ◽  
Number Of Factors ◽  
Ed Visits ◽  
The Mean ◽  
Using Data ◽  
Record Section

Background: COVID-19 pandemic effects are still being elucidated. Stay-at-home orders issued during peak of COVID-19 and social distancing as lockdown measures compounded with COVID-19 concerns have caused significant disruptions in daily life. One notable effect of these variables may be a change in the number of emergency department (ED) visits. This study aims to investigate the effects of COVID-19 on ED visits, and possible reasons for changes.Methods: Retrospective analysis using data for ED visits and procedures performed in the orthopaedics department of GMC Jammu were collected from the record section of GMC Jammu for four months prior and post implementation of lockdown and results were deduced with regards to the comparison in the number of visits, admissions and surgeries done pre and post-lockdown period.Results: The mean number of ED visits/admissions per day for the last four months of available data post lockdown due to COVID-19 pandemic was significantly less than the four months prior to COVID-19 pandemic.Conclusions: A number of factors have likely contributed to the substantial decrease in ED visits observed in this study. In light of these findings, it is important to raise patient awareness regarding conditions that require urgent ortho consultation so as to avoid any type of deformity/disability whatsoever.

scholarly journals Validity of mannheim peritonitis index in predicting outcome of patients with perforative peritonitis in a tertiary care centre Kerala, India

2019 ◽  
Vol 7 (11) ◽  
pp. 4140
Author(s):  
Alex Mathew ◽  
Joby John ◽  
Asha Sasikumar
Keyword(s):  
Likelihood Ratio ◽  
Tertiary Care ◽  
Prognostic Index ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
P Value ◽  
Care Centre ◽  
Roc Curve Analysis ◽  
Tertiary Care Centre ◽  
Perforation Peritonitis

Background: Perforation peritonitis is one of the most commonly encountered surgical emergencies in our country. The prognosis of secondary peritonitis remains poor despite development in diagnosis and management. Early identification of patients with severe peritonitis may help in selecting patients for aggressive surgical approach.Methods: The study was conducted in 128 cases of perforation peritonitis admitted and treated in the department of surgery in a tertiary care centre. Initial diagnosis was made on the basis of detailed history, clinical examination and presence of pneumoperitoneum on erect abdominal X-ray. Patients were first assessed using a predesigned Performa, then MPI score was calculated for each patient and the patients were followed-up till death or discharge from the hospital.Results: The ROC curve analysis shows area under the curve was 0.986 with a standard error of 0.008, 95% CI (0.971 to 1.001), p<0.0001. In our study authors found that for the MPI score of 26, sensitivity was 91.3% and specificity was 92.4%, with a positive likelihood ratio of 12.01 and a negative likelihood ratio of 0.09. Age of the patient, presence of organ failure, associated malignancy, generalised type of peritonitis and the original MPI Score has got a significant association with the final outcome (i.e. p value <0.05).Conclusions: MPI is an excellent prognostic index for peritonitis with high accuracy in individual prognosis that is cheap, cost effective, easily measurable and reproducible. The study accentuates that early diagnosis, appropriate resuscitation and prompt surgical intervention still remain the keystones in the management of perforation peritonitis.

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