scholarly journals Admission test as a screening test for fetal distress in labour

2018 ◽  
Vol 7 (3) ◽  
pp. 870
Author(s):  
Smitha B. Rao ◽  
Reena D’Souza ◽  
Bhavana Sherigar ◽  
Soumya R ◽  
Vismaya Kaveri ◽  
...  
Keyword(s):  
Screening Test ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Well Being ◽  
P Value ◽  
Care Hospital ◽  
Foetal Heart ◽  
Singleton Pregnancy ◽  
Admission Test

Background: This study was undertaken with the purpose of evaluating the efficacy of labour admission test as a screening test to identify the compromised fetus or fetus at risk and to correlate with perinatal outcome.Methods: This was a retrospective cohort study of 300 patients in 1st stage of labour admitted to labour room at tertiary care hospital over a period of one and a half years. Patients with Singleton pregnancy, Cephalic presentation & Gestational age beyond 34 weeks were included in this study. A BPL electronic foetal heart monitor was used to perform the admission test. With the patient in left lateral position a 20 minute continuous electronic recording (paper speed of 3 cm per minute) of foetal heart rate and uterine activity was obtained, on a cardiotocograph.Results: Statistical significance was calculated between different categories for different parameters too. A p value of of<0.05 was considered to be statistically significant. Fetal distress was seen 64.71% in Category III group 33.33% with Category II group and 4.74 % in Category I trace. admission test has 97.75% specificity and 95.5% negative predictive value.Conclusions: Admission test makes screening convenient. Since it is non-invasive, patients also cooperate. Admission test helps to plan subsequent management of labour. It is a good predictor of foetal well-being at the time of admission and for the next few hours.

scholarly journals An observational cohort study on the etiology and outcomes of neonates with thumb in flexion sign

2020 ◽  
Vol 8 (1) ◽  
pp. 138
Author(s):  
Sruthy Gnanasekaran ◽  
Natarajan P.
Keyword(s):  
Statistical Significance ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Language Delay ◽  
Research Centre ◽  
Secondary Outcome ◽  
P Value ◽  
Significant Finding ◽  
Care Hospital ◽  
Etiological Factors

Background: One constant observation by Pediatricians during postnatal rounds is that many of the early neonates exhibit a sign with thumb adducted and flexed over the palm and the rest of the fingers flexed over the thumb. In an otherwise normal neonate with no obvious etiological factors, we do come across TIF sign in more than half of the early neonate. This study attempts to know weather this sign is physiological or pathological and what would be the neurological outcome of the neonates exhibiting this sign in the early neonatal period.Methods: The study was conducted in the department of Pediatrics (post-natal ward in) of Sri Venkateshwara Medical College Hospital & Research centre, Ariyur, Puducherry, a tertiary care hospital loacted in a rural area.Results: Among 227 study participants 152(67%) had TIF sign. The infants born after history of fetal distress had higher incidence of TIF sign (76.1%) with a p value 0.05. One significant finding was that all the 7 infants who had language delay had history TIF sign within 7 days of life. The p value was 0.01.Conclusions: The pathological view of the TIF sign is, perhaps, a sign of minimal insult to the developing brain from which it recovers over a period of few months. From our study we conclude that the incidence of TIF sign was about 67 %. Thumb in Flexion sign has clinical significance with etiological factors like fetal distress in apparently healthy full-term infants. The secondary outcome of TIF sign was isolated language delay which was present in babies who had TIF sign within first week of life without neurological deficits up to 1 year of life with statistical significance. Hence it is recommended that the neonates with this sign need periodic neurological evaluation.

scholarly journals Factors influencing early initiation of breast feeding among mothers in North Coastal Andhra Pradesh, India

2019 ◽  
Vol 6 (10) ◽  
pp. 4316
Author(s):  
Kiran Pamarthi ◽  
Jugal Kishore Palli
Keyword(s):  
Breast Feeding ◽  
Andhra Pradesh ◽  
Tertiary Care ◽  
Early Initiation ◽  
P Value ◽  
Care Hospital ◽  
Feeding Problems ◽  
Singleton Pregnancy ◽  
Recent Trial ◽  
Positive Effects

Background: The benefits of breastfeeding for the health and wellbeing of the mother and babies are well documented. A recent trial has shown that early initiation of breastfeeding could reduce neonatal mortality, which would contribute to the achievement of the Millennium development goals. The positive effects of breastfeeding on the new-born’s health can be attributed to the components of breast milk, as well as the contact between mother and baby.Methods: This is a hospital based, cross sectional study conducted in the Department of Pediatrics and Department of Obstetrics and Gynaecology, at a tertiary care hospital in North Coastal Andhra Pradesh. Study period was one year between March 2018 to February 2019. 310 healthy term new-born babies of singleton pregnancy were included.Results: The prevalence of initiation of breast breastfeeding within one hour in this study is 48.7% (151 neonates). Hindu religion, literacy, urban residence, vaginal delivery, male child, breast feeding advice during antenatal period, birth spacing <2 years, not giving prelacteal feeds, absence of breast-feeding problems and maternal illness were found to have a significant association with initiation of breast feeding within 1 hour after delivery (p value <0.05).Conclusions: Innovative strategies like provision of breastfeeding counsellors in the hospital setup; constant counselling to mothers and their immediate relatives who take care of baby and mothers can increase early initiation of breast feeding.  

scholarly journals Labour admission test: a screening test for foetal distress in labour

2017 ◽  
Vol 6 (2) ◽  
pp. 452
Author(s):  
Mohd Rasheed ◽  
Ajay K. Srivastava
Keyword(s):  
Statistical Analysis ◽  
Predictive Value ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Well Being ◽  
P Value ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Short Period ◽  
Admission Test

Background: Labour is a very short period in the life of a foetus but poses the maximum threat. Improvements in medical technology have made it possible to monitor fetal well-being during labour. The introduction of labour admission test has proven to be of benefit in identifying patients at risk for developing distress and implementing timely intervention.Methods: The present study was undertaken to evaluate the same. This was a prospective study done on 500 patients above 37 weeks of gestation in cephalic presentation. EFM was done using oxford sonicaid 8002 CTG machine and Gem premier 3000 (model no 5700) arterial blood gas analyzer machine was used for determining the pH of fetal blood.Results: Statistical analysis was done using SPSS version 15.0 statistical analysis software. p value <0.001 was considered highly significant. Results revealed that a total of 105 (80.77%) babies had fetal distress in category II and III out of 135, whereas only 30 (8.11%) were distressed in category I out of 370. Test had a sensitivity of 77.7% and specificity of 93.15% with a positive predictive value of 80.7% and a negative predictive value of 91.89%.Conclusions: It has become evident that combined use of CTG with cord blood pH is more accurate way of predicting and diagnosing birth asphyxia.

scholarly journals A study of the risk factors of various arrhythmias in patients with coronary heart disease

2017 ◽  
Vol 4 (5) ◽  
pp. 1369
Author(s):  
Puneet Patil ◽  
Aamera Sait ◽  
Dilip Ratan Patil
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Statistical Significance ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Av Block ◽  
Cross Sectional ◽  
Multiple Risk Factors ◽  
Multiple Risk

Background: Complications like arrhythmias, cardiac failure, cerebrovascular and mechanical complications. Among these complications, arrhythmias are the most common complication of acute myocardial infarction. The objective of this study was to study the risk factors of various arrhythmias in patients with coronary heart disease.Methods: Present study was a hospital based cross sectional study conducted at department of General Medicine of a tertiary care hospital for a period of two years among 102 patients. Detailed history, clinical examination, investigation was done. All patients were followed for one year to assess the outcome among them. All data was entered in the Microsoft Excel worksheet and analyzed using proportions.Results: Arrhythmias were more common with low ejection fraction (72.73%). The overall mortality was 7.84%. Ventricular fibrillation was seen in 50% of the patients who did not receive thrombolytic therapy. First-degree AV block and second-degree AV block were present in 6.25% and 7.50% respectively and did not affect the mortality while complete heart block was present in 8.75% and mortality rate of 28.57% with right ventricular involvement. Risk factors like smoking, alcohol, hypertension, diabetes mellitus and obesity had higher incidence of arrhythmias but was not found to have any statistical significance (p >0.05). However, patients having multiple risk factors strongly associated with the high mortality in statistically significant manner (p value 0.0006).Conclusions: Patients with risk factors like smoking, alcohol, hypertension, diabetes mellitus and obesity had higher incidence of arrhythmias. Multiple risk factors increase the incidence of both arrhythmias and mortality (67% mortality with 4 risk factors and 75% mortality with 5 risk factors).

scholarly journals Study to Assess the Prescription Pattern and Quality of Life in Osteoarthritis Patients at a Tertiary Care Hospital

2020 ◽  
Author(s):  
Ansha Subramanian ◽  
Mangaiarkkarasi Adhimoolam ◽  
Selvalaxmi Gnanasegaran ◽  
Meher Ali Raja Mohammed
Keyword(s):  
Quality Of Life ◽  
Tertiary Care ◽  
Well Being ◽  
Joint Disease ◽  
P Value ◽  
Womac Pain ◽  
Care Hospital ◽  
Womac Index ◽  
Prescribing Trends

Introduction: Osteoarthritis (OA) often called wear and tear arthritis is a chronic progressive musculoskeletal joint disease with multifactorial aetiology, affecting millions of people around the world. It is one of the leading causes of morbidity, having major impact on Quality of Life (QoL) of the patient with substantial economic and social burden. OA can have a negative impact on health related QoL and psychological well-being of the individual. Aim: To evaluate the prescribing trends of drugs in the management of OA in a tertiary care teaching hospital and to assess the effect of pharmacotherapy on QoL of OA patients in terms of subjective and functional status using Western Ontario and McMaster Universities Arthritis index scale (WOMAC)-modified Centre for Rheumatic Disease (CRD) Pune version OA patients. Materials and Methods: Prospective observational study conducted among the OA patients in Orthopaedic Department over the period of one year between November 2014-December 2015. Adult patients of either gender diagnosed with OA for minimum period of three months were enrolled for the study. Out of 285 eligible patients, drug therapy of 256 patients’ data were analysed and they were given treatment by the treating orthopaedician. All the patients were asked to personally complete the WOMAC index scale during their first visit. They were followed-up for one month of pharmacotherapy in order to assess change in the WOMAC index scale. Data were analysed using Statistical Package for the Social Sciences (SPSS) software 16.0 version. The p-value <0.05 was considered statistically significant. Results: Among 256 patients who completed the study, the most frequently prescribed drug class was NSAIDs (82.1%). Acelofenac with Paracetamol combination (117) and Diclofenac monotherapy (44) were most commonly prescribed. Statistically significant reduction in the WOMAC (pain, stiffness and physical function) score was observed in the follow-up visit when compared to first visit (p<0.0001) after one month of pharmacotherapy in patients taking Diclofenac and Aceclofenac with Paracetamol combination. Conclusion: This study highlighted the significant improvement in QoL and significant reduction in WOMAC scores with Aceclofenac-Paracetamol combination and Diclofenac monotherapy in OA patients.

scholarly journals Thyroid disorders in pregnancy: prevalence and its fetomaternal outcome in a tertiary hospital of Delhi, India

2020 ◽  
Vol 9 (2) ◽  
pp. 549
Author(s):  
Neha Bansal ◽  
Divya .
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Group Versus ◽  
Fetal Distress ◽  
First Trimester ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Thyroid Disorders ◽  
Care Hospital

Background: This study was conducted to determine the feto maternal outcome in pregnant women with thyroid disorders. The prevalence of thyroid disorders in present study was 15.75%.Methods: This was a prospective observational study carried out in all pregnant women irrespective of their parity, who attended ANC clinic in department of obstetrics and gynaecology in a tertiary care hospital over a period of 2 years. After registering, the patients were followed up with routine antenatal visits up to delivery and records were reviewed for development of abortion, PIH, preterm delivery, GDM, anemia, placental abruption, still birth, anomalies, fetal distress, meconium stained liquor, low birth weight and neonatal outcome by neonate Apgar score and TSH value.Results: Mean age group in our study was 27.61±3.14. Family history was present in 8% of study group versus 0% in control group which was statistically significant (p=0.028). Eighteen percent of preeclampsia was diagnosed in study group as compared to 4% in control group which was statistically significant (p-value= 0.005). Fourteen percent patients had preterm labour in study group as compared to 6.7% in control group which was statistically significant (p value= 0.047). Increased neonatal TSH was found in study group (61.3%) as compared to control group (32%), this difference was statistically significant (p-value <0.001). There was increased importance of measuring TSH in first trimester as it was statistically significant in study group (p-value <0.001).Conclusions: All pregnant women should be screened for hypothyroidism as early as possible or before conception to prevent any fetomaternal complications.

scholarly journals Effectiveness Of Urine Dipstick In Diagnosis Of Pre-eclampsia

2019 ◽  
Vol 10 (1) ◽  
pp. 3-6
Author(s):  
Ferhat Uzair ◽  
Urooj Naz ◽  
Samia Shuja ◽  
Abdul Waheed ◽  
Tahira Assad
Keyword(s):  
Diagnostic Accuracy ◽  
Pregnant Women ◽  
Predictive Value ◽  
Tertiary Care ◽  
First Trimester ◽  
P Value ◽  
Care Hospital ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
Urine Dipstick

Objective: To determine the efficacy of urine dipstick in Pre-eclamplasia. Study Design and Setting: This was a cross-sectional study conducted at the department of obstetrics & gynecology of a tertiary care hospital from May-2017 to September-2018. Methods: All the pregnant women of age 15-45 years, BP=140/90 mmHg on two occasions 4 hours apart or single diastolic value of 100 mmHg, gestational age >20 weeks, singleton pregnancy, booked in first trimester of pregnancy were included in the study. Statistical package SPSS 22 was used for the analysis of data chi-square tests were applied for the diagnostic accuracy of urine dipstick in detection of Pre-eclampsia in pregnant women. P-value was <0.05 was considered as significant. Results: Total 211 pregnant women were enrolled in the study. Mean (SD) age was 28.26(3.86) years. Overall sensitivity and specificity of urine dipstick was found to be 94% and 95.4% respectively, positive predictive value 95%, negative predictive value 94.5% and excellent diagnostic accuracy 94.7% of urine dipstick was observed for the diagnosis of spot urine protein creatinine ratio CONCLUSION: Urine dipstick found to be sensitive and reliable test to screen pre-eclampsia

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

2020 ◽  
Keyword(s):  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Traumatic Head Injury ◽  
Keywords Epilepsy ◽  
College Hospital ◽  
Cross Sectional

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.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

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)

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