scholarly journals One-year retrospective study on clinical, investigational and operative correlation in a tertiary care hospital

Author(s):  
Basant Kumar Pati

Background: Ectopic pregnancy is a life-threatening emergency which is one of the important cause of maternal mortality. Ectopic pregnancy must be suspected in any woman in the reproductive age group, presenting with lower abdominal pain or vaginal bleeding. Our aim was to review all cases of ectopic pregnancy and determine the incidence, high risk factors, types of clinical presentation and mode of management.Methods: This was a retrospective cohort study, conducted at a tertiary care hospital. Medical records of all women with an ectopic pregnancy between 2016 and 2017 were seen. Demographic data, risk factors, clinical features, and mode of management were noted.Results: 90 patients, diagnosed with ectopic pregnancy during last one year was included in the present study, with an incidence of 1.2%. Majority of women were aged 20-30 years (50%). 74.4% cases were ruptured ectopic. The most common risk factors were previous ectopic (50%) and pelvic inflammatory disease (17.7%). Lower abdominal pain was seen in 80 (40.3%) patients. Majority of patients (91.1%) had tubal ectopic pregnancies. Most common mode of treatment was salpingectomy.Conclusions: Risk factors for ectopic pregnancy must be enquired and early diagnosis and management to be done to avoid maternal morbidity and mortality.

Author(s):  
Chembetei Kavitha Kiran ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti

Background: Vulvovaginitis is one among the major pathologies encountered in reproductive age group. Etiologies are always multiple and candidiasis, bacterial vaginitis and trichomoniasis account for 90% of etiology. The incidence is dependable upon multiple factors like age group, ethnicity, socioeconomic status, geographical locale. Improperly treated and untreated vulvovaginitis is associated with long term complications like infertility, pelvic inflammatory disease in nulliparous females and preterm labour, miscarriage, ectopic pregnancy, chorioamnionitis among pregnant females and recurrent UTIs, cervicitis, endometritis, increased risk of acquiring STIs among normal females. The present study was undertaken with the objective of understanding the etiologies associated with vulvovaginitis among women attending Obstetrics clinic of a tertiary care hospital. The risk factors associated with the conditions, the features of the vaginal discharge and symptoms associated with each etiology were studied.Methods: A cross sectional study for a period of one year was conducted among 200 female patients attending the Department of gynecology for vaginitis and evaluated for etiology. Patient’s risk factors, clinical history, symptoms were collected by questionnaire and specimens were collected from all the cases and processed as per standard guidelines. Bacterial vaginosis was confirmed based on Neugent’s criteria, Trichomoniasis by wet mount examination and candidiasis by culture. The study was approved by the institutional ethical committee.Results: 137 cases of vulvovaginitis were diagnosed based on etiology. Vulvovaginitis was most common among 27-36 years and in multiparous women. Most common causative agent was Candida (59.12%) followed by bacterial vaginosis (22.63%) and Trichomoniasis (18.25%). Vaginal discharge was the commonest symptom (100%) followed by malodor and vulval irritation. Following unhygienic practices was the commonest risk factor associated with Vulvovaginitis.Conclusions: A regular evaluation is mandatory for all the females attending hospital for vaginitis. Successful management reduces the morbid conditions and it’s essential to treat the conditions during the pregnancy which prevents the complications associated like preterm birth, miscarriage etc. and adverse outcomes.


2019 ◽  
Vol 6 (9) ◽  
pp. 3117
Author(s):  
Shyam Sundar Tandri ◽  
Ayathu V. S. Sai Mahesh

Background: Thyroid nodules are a common finding in general practice. These nodules are either solitary or multinodular. In the present study thorough evaluation of all the cases presenting with a solitary thyroid nodule (STN) is done. The clear overview of prevalence of STN, associated risk factors, its distribution and its percentage of malignancy, clinic-pathological correlation and findings on ultra-sonogram.Methods: A one year cross sectional study at a tertiary care hospital was done after ethical committee approval. All cases of thyroid with solitary thyroid nodule were included and socio demographic data, clinical examination and USG data was noted. Thyroid hormone profile, FNAC and HPE was performed for every case enrolled and data was noted. The data was analyzed using SPSS version 22.Results: 350 cases were enrolled with 44.42% prevalence and 61.43% were females. Maximum age group was 31-40 years with swelling as the most common sign. 81.14% were euthyroid, 6.3% of cases had lymph node involvement. Micro calcification in 69.7% of nodules and 78.65 were solid. 40.3% of the STN were of colloid on FNAC and 6% were malignant. Malignancy on HPE was 14.6% and papillary carcinoma was the most commonest and follicular least.Conclusions: All cases of STN require a thorough clinical approach supported by ultra-sonogram, FNAC and detailed HPE after surgery for evaluation of benign and malignant lesions. Fine needle aspiration cytology has become an invaluable, minimally invasive and reliable tool in the preoperative assessment of patients with suspicion of malignancy.


Author(s):  
Arati Behera ◽  
Ranjita Ghadei ◽  
Rudra Narayan Bal

Background: Ectopic pregnancy is a life-threatening emergency commonly encountered by medical practitioner. Diagnosis is frequently missed and should be considered in any women in the reproductive age group with abdominal pain or vaginal bleeding. The aim of the study is to assess the incidence, clinical presentation, risk factors, methods of diagnosis, treatment, outcome and complications.Methods: This was a prospective study at S.C.B. Medical college from January to December 2017. Parameters like age, parity, gestational period, risk factors, clinical presentations, findings on ultrasonogram and at surgery with morbidities associated with diagnosed cases of ectopic pregnancy (n=93) were noted and analysed with SPSS-19 software.Results: Incidence of ectopic pregnancy was 18/1000 deliveries. Maximum cases were in age group of 21 to 30 years (54.8 %) and parous (76.3%). Common risk factors were having history of abortions (46.2%), previous tubal sterilization (24.7%), having one or more caesarean section (17.2%) and h/o infertility (16.1%). Most common symptom was pain abdomen (96.8%). Commonest site was ampullo-isthmic region of tube and rupture was the commonest mode of presentation. All underwent laparotomy and unilateral salpingectomy was done in 86 % of cases. It contributed to 3.27 % of total maternal deaths.Conclusions: Suspicion in high risk group can direct one to investigate and diagnose early, thereby reducing morbidity, mortality and improving the prospect of future fertility.


2012 ◽  
Vol 34 (2) ◽  
pp. 44-50 ◽  
Author(s):  
AKM Moinuddin ◽  
Md Mizanur Rahman ◽  
Shaheen Akhter ◽  
Syeda Tabassum Alam ◽  
CA Kawser

Objective: Identifying the risk factors of poor seizure control in children in a setting of tertiary care hospital. Design: Retrospective study. Setting: Child Development and Neurology Unit in the department of Paediatrics of Bangabandhu Sheikh Mujib Medical University (BSMMU). Study period: January 2004 through December 2005. Subjects: One hundred and twenty epileptic children were studied. They were grouped into controlled group (seizure free for more than six months) and poorly controlled group (having one or more seizure per month over a period of six months or more and who had experienced trials of at least two different antiepileptic drugs at optimum doses alone or in combination with adequate compliance) at the end of intervention and compared. Results: In this study 76 (63.3%) children were male and 44 (36.7%) children were female. Out of 120 cases 79 (65.8%) were in controlled group and 41 (34.2%) cases had poorly controlled epilepsy. Mean age of the controlled group and poorly controlled group of children were 79 months and 40.3 months respectively. Focal epilepsy was found in 30 (68%) cases in controlled and in 14 (31.8%) cases of poorly controlled group and generalized epilepsy was found in 42 (72%) cases in controlled and in 19 (28.8%) cases in poorly controlled group. Idiopathic epilepsy was more common which was 37 (46%) in controlled group against 14 (34%) in poorly controlled group. But symptomatic and cryptogenic cases were more prevalent with poorly controlled group 57.5% than controlled group 53%. In poorly controlled group 48.8% had cerebral palsy in comparison to 22.8% of controlled group. Early onset of seizure before one year was 25.3% in controlled and 78% in poorly controlled group (odds ratio=.2322, p =.0082) and one or more seizure per week 43% in controlled and 92.7% in poorly controlled group (odds ratio=.1218, p=.0032) were found as risk factors of poorly controlled epilepsy. Conclusion: Early onset of seizure before one year, symptomatic epilepsy and one or more seizure per week at diagnosis were found as risk factors of poorly controlled epilepsy in children attending a tertiary care hospital. DOI: http://dx.doi.org/10.3329/bjch.v34i2.10216 BJCH2010; 34(2): 44-50


Author(s):  
Bhavana Pandey ◽  
Devesh Kumar Shukla

Background: RTIs/STIs are a common public health problem in developing countries, contributing to a huge economic burden among individuals and health systems. RTI's excluding HIV constitutes the second major cause of disease burden (after maternity related causes) in women of developing countries. This cross sectional study is carried out with objectives of, to study socio-economic profile of respondents and to determine socio-economic factors of RTI, affecting the women of reproductive age group attending CIMS, Hospital Bilaspur (C.G.).Methods: A descriptive cross sectional study conducted in a tertiary care hospital CIMS, Bilaspur (Chhattisgarh) from May 2015 to October 2016. Total 450 cases were studied. Predesigned and pretested questionnaire was used to collect information regarding the socio-demographic profile and clinical profile of women’s regarding RTI. Statistical analysis was done using SPSS and Chi-square test was applied.Results: 4.3% (450) patient attending Obstetrics and Gynecology OPD were found to be suffering from RTI. Out of the 450 women, 83.8% of the women had experienced at least one symptom suggestive of RTI previously. Abnormal vaginal discharge was reported by 88.9% followed by lower abdominal pain (78.9%), genital ulcer (34%) and menstrual irregularity 75.8% of women. Symptoms of RTI were higher in old age, illiterate, those with employed, rural residential, Schedule tribe category, poor socio-economic status, separated, divorce and widow and women their husband educated up to primary class.Conclusions: Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.


2018 ◽  
Vol 27 (2) ◽  
pp. 22-26
Author(s):  
NA Parveen ◽  
MM Sarker ◽  
MK Sarker

Ectopic pregnancy is a common life-threating condition. Diagnosis is frequently missed and should be considered in any women in the reproductive age group presenting with abdominal pain or vaginal bleeding. This prospective observational study was conducted in RMCH to determine the incidence, risk factors, clinical presentation, treatment, morbidity and mortality associated with ectopic pregnancy. A total of 50 cases of ectopic pregnancy were operated during the study period giving the incidence of ectopic pregnancy of 8.02/1000 pregnancies. The age of the patient ranged from 18-37 years, with maximum (40%) between 26-30 years age group. 36% patients had delivered one child and 24% were nulliparous. 30% patients had pelvic inflammatory disease and 22% had history of previous abortion/ MR. All patients presented with lower abdominal pain, 68% presented with abnormal vaginal bleeding and 60% had amenorrhoea. Most of the patients were diagnosed by high clinical suspicion and confirmed by USG. 96% cases ectopic pregnancy occurred in the fallopian tube and ampullary part was mainly affected. Laparotomy followed by unilateral salphingectomy was performed in majority (60%) of cases. 22% cases ipsilateral salpingectomy with tubectomy other side and 12% cases salpingostomy were performed. The recovery of majority of patients was smooth and uneventful. There was no death in this study.TAJ 2014; 27(2): 22-26


2016 ◽  
Vol 21 (4) ◽  
pp. 236
Author(s):  
Saadia Rasheed ◽  
Sehar Shahbaz ◽  
Shazia Hammad

AbstractAims and Objectives:Determine the frequency of unruptured ectopic pregnancy in a tertiary care hospital of Hail City, Saudi Arabia.Study Design:It was an observational case series.Material and Method:A total of 150 cases between 15 44 years with history of amenorrhea (6 8 weeks) and vaginal bleeding with or without lower abdominal pain, positive urine pregnancy test were enrolled in the study while heterotopic pregnancy, ruptured ectopic pregnancy and patients in first trimester with obstetric problem other than ectopic pregnancy were excluded from the study. All these cases were collected from Maternity and Childrens hospital Hail, Kingdom of Saudia Arabia during 2011 to 2014.Results:In our study, 64.67% (n = 97) of the cases were between 15 30 years of age while 35.33% (n = 53) were between 31 44 years, mean sd was calculated as 26.34 2.67 years, frequency of unruptured ectopic pregnancy was recorded in 14% of the cases.Conclusion:The frequency of un-ruptured ectopic pregnancy is higher and TVS may be used for early detection of this morbidity.Key Words:Ectopic pregnancy, un-ruptured, Transvaginal sonography.


Author(s):  
Mahima Jain ◽  
Devanshi Dave

Background: Obstetric hysterectomy was developed as a heroic operation arising out of necessity to control post-partum haemorrhage thereby reducing maternal mortality. The objectives of this study are to examine the incidence, indications, outcomes and complications of obstetric hysterectomy in a tertiary care hospital. It also aims to study the changing trends in incidence and indications in present day obstetric practice.Methods: This is a one-year study including 31 cases of obstetric hysterectomy performed in the Department of Obstetrics and Gynecology in a tertiary care hospital of Gujarat. Each case is analyzed, computed and tabulated as per standard proforma including clinical assessment, questionnaire, examination and investigations.Results: In present study 68% cases were in 21-30 years which is peak reproductive age. 55% patients were from rural areas and 52% cases were having three or more parity. The incidence of obstetric hysterectomy is 0.432% in both vaginal and cesarean deliveries i.e. 1 in 231 deliveries. Major indication for obstetric hysterectomy is morbidly adherent placenta 32% followed by atonic PPH 25.8% and ante partum hemorrhage in 22.58% due to increase in rate of cesarean sections. Most common complication is DIC and maternal mortality in around 16.12%.Conclusions: Obstetric hysterectomy is still a lifesaving surgery in modern day obstetrics. Quick decision for obstetric hysterectomy reduces maternal morbidity and mortality. Most of the morbidity is attributable to its indication and underlying disorder rather than the procedure itself.


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