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 Observational Study on Clinical Features, Treatment and Outcome of COVID 19 in a tertiary care Centre in India- a retrospective case series

2020 ◽  
Author(s):  
Raja Bhattacharya ◽  
Rohini Ghosh ◽  
Manish Kulshrestha ◽  
Sampurna Chowdhury ◽  
Rishav Mukherjee ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Standard Of Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Demographic Profile ◽  
Acetyl Cysteine

ABSTRACT Objective: This study will attempt to explore the demographic profile and outcome in the patients receiving multidisciplinary, personalised approach including use of Broad Spectrum Antivirals - Ivermectin, anti-inflammatory and antioxidants roles of Statins and N-acetyl-cysteine along with Standard of Care (SOC) in hospitalised COVID19 patients in a tertiary care centre. Setting: Inpatient department Participants: 191 COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the year 2020 between June 14- 28, 2020 Main outcome measures: The outcome of Interests are : Studying the demographic profile of COVID 19 cases Study the treatment outcomes in terms of death or discharge in patients receiving Ivermectin+N-acetyl-cysteine+Statin along with Standard of care. Results: 148 patients were included in the study. All of them had confirmed COVID19 infection by the rtPCR method. Average age of the patients was 57.57 years ( Range = 17 - 88), 49% were male, 51% female. 81% of the patients had at least one or more comorbidities. Most common comorbidities included diabetes( 32%), Hypertension (27%),Ischaemic Heart Disease (8%). More comorbidities. The in hospital, Case Fatality Rate was therefore, 1.35 %. The remaining 144 were discharged from the facility after an average 12 days duration of stay. Conclusions: Triple therapy with ivermectin + atorvastatin + N-acetylcysteine can be an useful adjunct to standard of care. Keywords: SARS-CoV-2, COVID-19, outpatients, treatment, zinc, hydroxychloroquine, azithromycin

scholarly journals OBSERVATIONAL STUDY ON CLINICAL FEATURES, TREATMENT AND OUTCOME OF COVID 19 IN A TERTIARY CARE CENTRE IN INDIA - A RETROSPECTIVE CASE SERIES

2020 ◽  
pp. 1-3
Author(s):  
Raja Bhattacharya ◽  
Indranil Ray ◽  
Rishav Mukherjee ◽  
Sampurna Chowdhury ◽  
Manish Kulasreshtha ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Standard Of Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Demographic Profile ◽  
Acetyl Cysteine

Till date, no proven therapy exists for treatment of SARS-coV-2 infections which has been de-clared a pandemic by WHO in March, 2020. Objective: This study will attempt to explore the demographic profile and outcome in the pa-tients receiving multidisciplinary, personalised approach including use of Broad Spectrum Antivi-rals - Ivermectin, anti-inflammatory and antioxidants roles of Statins and N-acetyl-cysteine along with Standard of Care (SOC) in hospitalised COVID19 patients in a tertiary care centre. Setting: Inpatient department (designated COVID ward) Participants: COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the year 2020 between June 14- 28, 2020. Main outcome measures: The outcome of Interests are : a. Studying the demographic profile of COVID 19 cases b. Study the treatment outcomes in terms of death or discharge in patients receiving Ivermectin+N-acetyl-cysteine+Statin along with Standard of care. Results: 148 patients were included in the study. All of them had confirmed COVID19 infec-tion by the rtPCR method. Average age of the patients was 57.57 years ( Range = 17 - 88), 49% were male, 51% female. 81% of the patients had at least one or more comorbidities. Most com-mon comorbidities included diabetes( 32%), Hypertension (27%),Ischaemic Heart Disease (8%). More comorbidities. The in hospital, Case Fatality Rate was 1.35 %. The remaining 146 were dis-charged from the facility after an average 12 days duration of stay. Conclusions:. Triple therapy with Ivermectin, N-acetyl-cysteine and Atorvastatin along with standard of care is safe and effective in SARS-coV-2 infection.

scholarly journals Accidental tramadol ingestion in children admitted in tertiary care centre

2019 ◽  
Vol 8 (12) ◽  
pp. 2661
Author(s):  
Vadlakonda Sruthi ◽  
Annaladasu Narendra
Keyword(s):  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Hemodynamic Instability ◽  
Tertiary Care Centre ◽  
Medical College ◽  
History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

scholarly journals Cross sectional study to assess the awareness of pharmacovigilance among post graduate residents of tertiary care medical college hospital of central India

2018 ◽  
Vol 7 (3) ◽  
pp. 386
Author(s):  
Pooja Solanki Mishra ◽  
Gopal Gudsurkar
Keyword(s):  
Graduate Student ◽  
Single Point ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Post Graduate ◽  
Global Database ◽  
Medical College ◽  
Post Graduate Student

Background: Pharmacovigilance knowledge and awareness in post graduate student doctors is key factor for proper implementation of PvPI. This study was planned to evaluate the knowledge &awareness of pharmacovigilance in post graduate students in tertiary care centre in Indore.Methods: It was a single point cross sectional questionnaire-based study conducted in a tertiary care Institute MGM Medical College & M.Y. Hospital in the state of Madhya Pradesh at Indore. It was conducted among post graduate student doctors from various clinical departments. Total of 150 questionnaires were distributed, 115 of them were returned back and were analysed.Results: Overall knowledge level was satisfactory. 91.30% knew about ADR while 95% were aware about PVPI. 13% knew about local AMC at Indore while only 4.34% knew global centre for Pharmacovigilance is at Sweden Uppsala. 86.95% thought Med watch as global database for ADR against only 13% knew its Vigibase. 96.50% thought ADR reporting is necessary. 97.40% thought it should be included in UG curriculum. 95.65% had not reported any ADR till date while 86.95% had not seen an ADR form.Conclusions: Post graduate doctors are the prime candidates to impart the importance of pharmacovigilance. The study strongly suggested that there was a great need to create awareness among the post graduate doctors to improve the reporting of ADRs.

scholarly journals Spectrum of dengue morbidity in pregnancy and its impact on maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1511
Author(s):  
Anuradha G. ◽  
Sandya M. R. ◽  
Shirley George
Keyword(s):  
Dengue Infection ◽  
Tertiary Care ◽  
Dengue Shock Syndrome ◽  
Severe Form ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Medical College ◽  
Still Births ◽  
Record Review ◽  
In Pregnancy

Background: Dengue is a vector borne viral infection with seasonal outbreaks every year. The spectrum varies from just a febrile morbidity to the severe form of dengue shock syndrome (DSS). The objective of the present study was to study the influence of dengue fever on pregnancy and to analyze the maternal and perinatal outcome.Methods: Thirty-six pregnant women beyond 28weeks of gestation who tested positive for dengue infection were retrospectively analyzed during a 5year study period (Jan 2014-Dec 2018). The study was conducted in the Department of OBGYN St John’s Medical College Hospital, Bangalore. Thirty-three of these patients delivered at St John’s and there were three postpartum referral cases. The necessary data was obtained by patient record review. The data was analyzed using SPSS and the results were expressed as Mean±SD and percentages.Results: Out of 36 women analyzed the mean age was found to be 23.93±4.5 years. Majority were primigravidae (58.3%). The most common clinical manifestation was fever seen in 47.2%. Twenty five percent of patients had platelet count of <20,000 on admission. Overall 66% of the patients required transfusion. Nearly fifty three percent of the patients had vaginal delivery. There were 4 maternal mortalities (11.1%) and 2 perinatal mortalities (5.5%) both were still births in the present study.Conclusions: Dengue infection in pregnancy was associated with increased maternal and perinatal morbidity as well as mortality. The severity of the infection has direct impact on the outcome. Hence early diagnosis and prompt management in a tertiary care centre, with multidisciplinary approach improves the outcome and minimizes the complications.

Management and Outcomes of Interstitial Ectopic Pregnancies at a Tertiary Care Centre: a Retrospective Case Series

2018 ◽  
Vol 40 (6) ◽  
pp. 852
Author(s):  
Angel Shan ◽  
Mary Ellen Conway ◽  
Lindsay Machan ◽  
Laura Cormack ◽  
Nadia Branco ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Ectopic Pregnancies

Concurrent surgeries in ENT: a cost-effective and safe approach in patients requiring multiple definitive procedures

2004 ◽  
Vol 118 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Achamma Balraj ◽  
Mary Kurien ◽  
Anand Job
Keyword(s):  
Surgical Procedures ◽  
Tertiary Care ◽  
Case Series ◽  
Cost Effective ◽  
Definitive Treatment ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Average Hospital ◽  
Duration Of Surgery

Treatment of the predisposing factors that are identified in the nose and throat in several ENT diseases is mandatory prior to the definitive management of the latter. When surgical management is indicated it has been traditional to use staged procedures. This study was undertaken to assess the role of concurrent surgical procedures in ENT and evaluate their cost-effectiveness compared to similar staged procedures. This was a retrospective case series of 100 consecutive patients undergoing concurrent and similar staged ENT surgical procedures. On analysis, it was noted that the average duration of surgery, anaesthesia and hospital stay was significantly less in the concurrent procedures group than in the staged procedures (2.35/3.1.hours; 3.05/3.30.hours and 2.5/6.5 days, respectively). The average hospital bill for the concurrent procedures was also lower than for the staged procedures. Hence, in patients requiring multiple ENT surgical procedures for definitive treatment, concurrent procedures are more cost-effective than staged procedures and should be considered the treatment of choice in a tertiary care centre.

scholarly journals A Step towards Control of Multidrug Resistant Tuberculosis: Hospital Based Study from Nashik India

2016 ◽  
Vol 12 (2) ◽  
pp. 34-38
Author(s):  
SV Gosavi ◽  
M Patil ◽  
B Almale ◽  
S Dugad
Keyword(s):  
Case Series ◽  
Previous Treatment ◽  
Multidrug Resistant ◽  
Research Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Medical College ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Introduction: The Global TB report (2012), estimates 73,000 MDR TB patients living in India, among them only 1,660 cases were notified and 68.4% cases were put on treatment. Hence, this study was conducted with objective to assess the treatment outcome of multi drug resistant Tuberculosis patients enrolled in DOTS plus (Cat-VI) site.Methodology: It is a retrospective case series of MDR-TB cases conducted at Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik (Maharashtra). Information was collected on age, gender, HIV status, previous treatment of TB, weight of patient, refused to take treatment for Cat IV. Outcome was recorded in terms of cure rate, rate of failure, defaulter, treatment completed, switch to Cat V and death.Results: Among the study subject, majority of study subjects were male (65%) and highest proportion (49%) of MDR-TB was in 25-44 years of age. Out of 353 patient 241 (68.4%) were still on Cat IV in which 35% patient’s on intensive phase and 65% put on continuation phase while 12.8%, 13.5%, 4%, 1.1%, 3.6% & 0.5% patient were found to be defaulted, died, refused to take treatment, treatment completed, transfer out & switch to Cat V, respectively.Conclusion: In the present study, the majority of study subjects (99.4%) were previously treated for TB, we identified number of operational challenges in the treatment of MDR-TB like rate of defaulter, refuse to take treatment & deaths among MDR-TB patient was high. There is need to study correlates of these factors in details also need of operational research to improve MDR-TB treatment in India is considered as priority.SAARC J TUBER LUNG DIS HIV/AIDS, 2015 XII (2), page: 34-38

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