scholarly journals A study of the outcome of pregnancy complicated by obstetric cholestasis

2018 ◽  
Vol 7 (3) ◽  
pp. 996
Author(s):  
Samik Medda ◽  
Sibani Sengupta ◽  
Upasana Palo
Keyword(s):  
Neonatal Outcome ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Adverse Outcomes ◽  
Number Of Patients ◽  
Common Causes ◽  
Fetal Surveillance ◽  
Meconium Staining ◽  
One Year ◽  
Period Of Gestation

Background: Obstetric cholestasis is one of the most common causes of liver disease in pregnancy. Present study was carried out to study the incidence of Obstetric Cholestasis and its feto-maternal outcome in a tertiary care hospital.Methods: It is a prospective epidemiologycal study during a period of one year (2014 to 2015) over 100 pregnant ladies suffering from pruritus and detected as having Obstetric Cholestasis. They were followed up and maternal as well as fetal-neonatal outcome recorded. Appropriate statistical analysis done as applicable.Results: The incidence of Obstetric Cholestasis in our hospital was 9.9%. Majority of cases (43.0%) are diagnosed in late gestational age, mostly during 28 to 32 weeks period of gestation. Maternal morbidities are due to sleep disturbance (60/100), dyslipidemia, coagulation abnormality, PPH (10.0%) and increase chance of operative delivery (66.0%). Neonatal morbidities are mainly due to fetal distress, prematurity (22.0%), low birth weight (32/100) and meconium staining of amniotic fluid (42.0%). Maximum number of patients are delivered at 37 to 38 weeks, due to active and early intervention.Conclusions: Early diagnosis and active maternal and fetal surveillance is of utmost importance to avoid adverse outcomes.

scholarly journals Justification of Cesarean section in fetal distress: Experience in a tertiary care military hospital in Bangladesh

2019 ◽  
Vol 10 (1) ◽  
pp. 60-63
Author(s):  
Shakila Khanum ◽  
Liza Chowdhury
Keyword(s):  
Intensive Care ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Fetal Distress ◽  
High Rate ◽  
Military Hospital ◽  
Cross Sectional ◽  
Heart Rate Pattern

Background: The trend of Caesarean section (CS) carried out is rising worldwide. One of the most common indications of CS is fetal distress which is based on the cardiotocograph (CTG) recording, abnormal fetal heart rate pattern and meconium stained liquor. The aim of this study was to carry out an audit of CS performed due to fetal distress in a tertiary care military hospital with a view to justify the methods for diagnosis of fetal distress to fetal outcome. Methods: This cross-sectional observational study was carried out over a period of 1 year and 6 months (July 2013 to January 2015) in the Combined Military Hospital (CMH), Dhaka. All pregnant women at or beyond 37 weeks of gestation who underwent CS for fetal distress were included. Neonatal outcome were assessed based on APGAR score and neonatal intensive care admission. Results: Among the 260 (100%) women who underwent CS due to fetal distress, mean age was 27.8 ± 5.3 years. More than half (54.6%) of the women were primigravida. Majority (48%) of the patients presented with spontaneous onset of labor and in 43% cases labor was induced by medical methods. In the majority (40%) of the patients, fetal distress was diagnosed by seeing abnormal patterns in CTG. During CS, signs of fetal distress was found in the majority (64.6%) of the patients (meconium stained liquor 42.3%, cord abnormality 13.5% and placental abnormality 8.8%). APGAR score of the newborn babies was abnormal (<7) in the majority (60%) cases. More than half of the newborn babies required admission in neonatal intensive care unit for different diagnosis. There was only 4 (1.5%) cases of neonatal death. Conclusion: The rate of CS for fetal distress in this study was comparable to other study findings and within recommendation of WHO. The high rate of identifiable causes of fetal distress as well as neonatal outcome justifies doing CS in these cases. Birdem Med J 2020; 10(1): 60-63

scholarly journals Prediction of Gestational Diabetes Mellitus by Serum Uric Acid Levels: Prospective Analysis at a Rural Tertiary Care Center

2021 ◽  
Vol 6 (2) ◽  
pp. 283-285
Author(s):  
Deepika Kapil ◽  
Uday Mahajan
Keyword(s):  
Diabetes Mellitus ◽  
Uric Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Serum Uric Acid ◽  
Care Center ◽  
Tertiary Care ◽  
Medical College ◽  
One Year ◽  
Period Of Gestation

Serum uric acid has been recommended to screen gestational diabetes during pregnancy. Objective: Prediction of gestational diabetes by serum uric acid levels at 17-20 weeks. Methods: Eighty pregnant women who reported to the antenatal OPD at 17-20 weeks of period of gestation were enrolled in the study over the period of one year from Jan 2018 to Dec 2018 at Department of Obstetrics & Gynaecology Dr Rajendra Prasad Govt. Medical College, Kangra at Tanda, Himachal Pradesh, India. Results: Out of 8 patients, who developed GDM 4 (50%) had serum uric acid >3.5 mg/dl and 4 (50%) had serum uric levels <3.5 mg/dl. And the sensitivity of serum uric acid was 50% and specificity was 67%. Out of 8 patients, who developed GDM 4 (50%) had serum uric acid >3.5 mg/dl and 4 (50%) had serum uric levels <3.5 mg/dl. And the sensitivity of serum uric acid was 50% and specificity was 67%. Conclusion: Serum uric acid can be used to predict gestational diabetes. Keywords: Serum uric acid, gestational diabetes mellitus.

scholarly journals A clinico pathological correlation in leprosy in a tertiary care teaching institution

2019 ◽  
Vol 5 (4) ◽  
pp. 870
Author(s):  
Ramesh A. ◽  
Sampath V. ◽  
Shvedha M.
Keyword(s):  
Clinical Diagnosis ◽  
Tertiary Care ◽  
Clinical Information ◽  
Lepromatous Leprosy ◽  
Female Ratio ◽  
Histopathological Findings ◽  
Medical College ◽  
Number Of Patients ◽  
One Year ◽  
Madras Medical College

<p class="abstract"><strong>Background:</strong> Leprosy is a chronic infectious granulomatous disease caused by <em>Mycobacterium leprae</em>. The disease primarily affects peripheral nervous system, the skin and certain other tissues. It is a spectral disease which is classified into five groups based on clinical, histopathological and bacteriological and immunological criteria as tuberculoid (TT), borderline tuberculoid (BT), mid-borderline (BB), borderline lepromatous (BL), lepromatous (LL) according to Ridley-Jopling classification. Adequate clinical information combined with histopathology and bacteriological index is helpful not only in classification of different types of leprosy, but also useful for management of cases.The objective of the study was to correlate clinical diagnosis with histopathological findings of leprosy.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted for one year from January to December 2018 in Leprosy clinic, Department of Dermatology, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai. The histopathological findings were compared with clinical diagnosis.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total number of cases attended leprosy clinic from January 2018 to December 2018 was 167 cases, among those 49 clinically diagnosed cases were included in the study. Out of 49 cases, maximum number of patients belonged to 30-50 years age group. Male to female ratio was 3.9: 1. Hypopigmented, hypoaesthetic patches were commonly seen. Clinically as well as histopathologically BT leprosy was common.The maximum histological correlation seen in lepromatous leprosy (100%) followed by BT (80%).</p><p class="abstract"><strong>Conclusions:</strong> The study emphasises the role of skin biopsy in confirming the clinical diagnosis of leprosy and also as a therapeutic guide.</p>

scholarly journals Clinicopathological study of breast lesions over a period of one year in a tertiary care center

2018 ◽  
Vol 6 (10) ◽  
pp. 3397
Author(s):  
Divyasree Neeli ◽  
Bhagyalakshmi Atla ◽  
Satish Kumar Seeram ◽  
Lavanya Latchupatula ◽  
Srikanth Reddy Kamireddy
Keyword(s):  
Breast Carcinoma ◽  
Care Center ◽  
Tertiary Care ◽  
Duct Cell ◽  
Histopathological Diagnosis ◽  
Breast Lesions ◽  
Adequate Treatment ◽  
Molecular Features ◽  
Number Of Patients ◽  
One Year

Background: Breast carcinoma is no longer seen as a single disease but rather a multifaceted disease comprised of distinct biological subtypes with varied natural history, presenting a diverse spectrum of clinico-pathological and molecular features with different therapeutic and prognostic implications. The present study was designed to evaluate the frequency, age, gender and histopathological features of breast carcinoma in a tertiary care hospital.Methods: The present study is a hospital based retrospective study for a period of one year from January 2015 to December 2015, conducted in the Department of Pathology, Andhra Medical College, Visakhapatnam.The clinical details were recorded as per the proforma. Tissue for H&E sections were fixed in 10% formalin and subjected to routine paraffin embedded processing and stained with Hematoxylin and Eosin.Results: Out of the total 185 cases of breast lesions, 151 cases (81.62%) were diagnosed as non-malignant and 34 cases were malignant (18.37%). Maximum number of patients, 106 cases (57.2%), were between 21 - 40 years. Out of 34 malignant breast lesions, 27 were diagnosed as Infiltrative duct cell carcinoma (79.41%), followed by medullary carcinoma 4 cases (11.76%).Conclusions: The pattern of breast lesions provides valuable information concerning clinicopathological profile of breast lesions. The clinical diagnosis of a breast lump must be correlated with histopathological diagnosis for correct and adequate treatment of patient.

scholarly journals PATTERNS OF PRESCRIPTION AND ADR MONITORING OF DRUGS IN THE MANAGEMENT OF NEUROPATHIC PAIN IN A TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 55
Author(s):  
SUBHRANSU SEKHAR JENA ◽  
MONALISA JENA ◽  
NIBEDITA PATRO ◽  
SWATI MISHRA ◽  
MAITREYEE PANDA ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Tertiary Care ◽  
Drug Efficacy ◽  
Number Of Patients ◽  
The Central Nervous System ◽  
And Gender ◽  
Fatal Adverse Events ◽  
One Year

Objective: Neuropathic pain arises from damage or pathological changes in the peripheral or central nervous system. The pain is difficult to treat as standard treatment with conventional analgesics doesn`t typically provide effective relief of pain. Methods: It was a one-year study of utilization and analysis of prescriptions for PNDs (Painful neuropathic disorders). The parameters evaluated were demographic profile of the patient (age and gender), type and etiology of PNDs, drug data (name of the group of drugs with individual drugs, mono or polytherapy, number of drugs per prescription, formulation) and associated adverse drug reactions (ADR) with the prescribed drug. Results: Maximum number of patients of PNDs resides in the age group of 18 – 35 yrs (41.2%) & more common in females. The most common PND encountered was painful diabetic neuropathy (43.9%) followed by cervical and lumbar radiculopathy, postherpetic neuralgia. 2942 drugs were prescribed in 1020 prescriptions out of which 96.8% were oral and 3.2% were topical formulations. Most frequently prescribed group of the drug was tricyclic antidepressants (27.3%) followed by anticonvulsants (25.3%). Polypharmacy was seen 89.7% as compared to monotherapy (10.3%). Only 132 ADRs of various types were seen. The most common organ system affected was the central nervous system followed by gastro intestinal systems. The most common drugs implicated for ADRs were TCAs (24.4%), anticonvulsants (16.6%), and Pregabeline (9.8%). There were no fatal adverse events. Mild to moderate ADRs included constipation, nausea, vomiting, drowsiness, dryness of mouth. Conclusions: The choice of drug depends on etiology of neuropathic pain, drug efficacy and availability and also on ADR profile.

scholarly journals Acute Flaccid Paralysis with Acute Encephalitis Syndrome at a tertiary care centre of eastern Nepal 

2017 ◽  
Vol 13 (1) ◽  
pp. 216-219
Author(s):  
Shipra Chaudhary ◽  
Rupa Rajbhandari Singh ◽  
Nisha Keshary Bhatta ◽  
Gauri Shankar Shah ◽  
Jyoti Agrawal
Keyword(s):  
Acute Flaccid Paralysis ◽  
Tertiary Care ◽  
Altered Mental Status ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Tertiary Care Centre ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Common Causes ◽  
One Year

Background & Objectives: Acute encephalitis syndrome (AES) can have widely varied presentation. Hence this study was done to find out clinical features and outcome of Acute Enecphalitis Syndrome (AES) with Acute Flaccid Paralysis (AFP).Materials & Methods: A Prospective hospital-based study was carried out over one-year period, including all cases fulfilling AFP case definition. All cases of AFP meeting AES definition were further analysed in terms of history, clinical examination, investigations and outcome. Statistical analysis was done using SPSS version 17. Results: Out of total 43 children with AFP, 23 (53.5%) children  had AES. Amongst AFP with AES, altered mental status and seizures were present in 87% and 74% respectively. The mean Glasgow Coma Scale (GCS) was 7.61±3.65. Predominant weakness pattern was quadriparesis (87%). Cerebrospinal fluid was abnormal in 11 (47.9%) children with Japanese encephalitis (JE) positive 8.7%. Amongst 60.9% children with complications, respiratory failure (52.1%) was the most common. During 60-day follow-up, 11 (47.9%) children expired while 2 (8.7%) still had residual paralysis. Conclusion: AES is one of the common causes of AFP besides other causes. AFP with AES is commonly associated with quadriparesis, low GCS, respiratory complications, neurological sequelae and a high mortality. Thus, this study stresses upon the importance of AES surveillance along with AFP surveillance. 

scholarly journals Analysis of factors responsible for intrauterine fetal death in rural pregnant women at tertiary care centre of Northern India

2017 ◽  
Vol 6 (9) ◽  
pp. 4071 ◽  
Author(s):  
Shaveta Garg ◽  
Naina Kumar
Keyword(s):  
Fetal Death ◽  
Tertiary Care ◽  
Intrauterine Fetal Death ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Northern India ◽  
Number Of Patients ◽  
Tragic Event ◽  
Abruptio Placenta ◽  
One Year

Background: Intrauterine fetal death (IUFD) is a tragic event for both the parents and obstetrician. Objectives of current study were to study the underlying etiology of Intra Uterine Fetal Death (IUFD) that can be helpful in formulating the preventive measures.Methods: This study was conducted over a period of one year from April 2016 till March 2017 at a tertiary rural care hospital. All patients with diagnosed IUFD at >24 weeks of gestation were included in the study.Results: Total eighty patients were admitted with diagnosis of intrauterine fetal death. Among these majority 58 (72.5%) were multigravida and only 22 (27.5%) were primigravida. Maximum number of patients, 61 (72.5%) were between age group of 20-30 years. Maximum number of IUFD were reported between 36-40 weeks of gestation (36.25%). Most of fetal deaths were due to preventable conditions like hypertensive disorders of pregnancy (28.75%), severe anemia (15%), abruptio placenta (11.25%), and rupture uterus (10%). Out of these patients 68 (85%) delivered vaginally and 7 patients were delivered by LSCS.Conclusions: The present study emphasizes the role of health education, regular antenatal checkups, early detection of complications and hospital delivery to reduce the overall preventable IUFD.

scholarly journals The Epidemiology of Injuries in Adults in Nepal: Findings from a Hospital-Based Injury Surveillance Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12701
Author(s):  
Santosh Bhatta ◽  
Dan Magnus ◽  
Julie Mytton ◽  
Elisha Joshi ◽  
Sumiksha Bhatta ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Injury Surveillance ◽  
Prospective Surveillance ◽  
Senior Managers ◽  
Number Of Patients ◽  
Common Causes ◽  
Self Harm ◽  
One Year ◽  
Injured Patients

This study aimed to develop and evaluate a model of hospital-based injury surveillance and describe the epidemiology of injuries in adults. One-year prospective surveillance was conducted in two hospitals in Hetauda, Nepal. Data were collected electronically for patients presenting to emergency departments (EDs) with injuries between April 2019 and March 2020. To evaluate the model’s sustainability, clinical leaders, senior managers, data collectors, and study coordinators were interviewed. The total number of patients with injuries over one year was 10,154, representing 30.7% of all patients visiting the EDs. Of patients with injuries, 7458 (73.4%) were adults aged 18 years and over. Most injuries (6434, 86%) were unintentional, with smaller proportions due to assault (616, 8.2%) and self-harm (408, 5.5%). The median age of adult patients was 33 years (IQR 25–47). Males had twice the rate of ED presentation compared with females (40.4 vs. 20.9/1000). The most common causes were road traffic accidents (32.8%), falls (25.4%), and animal/insect related injuries (20.1%). Most injured patients were discharged after treatment (80%) with 9.1% admitted to hospital, 8.1% transferred to other hospitals, and 2.1% died. In Nepal, hospital-based injury surveillance is feasible, and rich injury data can be obtained by embedding data collectors in EDs.

scholarly journals Prevalence of oral mucosal lesions in a tertiary care centre: one-year prospective study

2020 ◽  
Vol 6 (9) ◽  
pp. 1704
Author(s):  
Smruti Milan Tripathy ◽  
Poonji Gupta ◽  
Akshay Jain ◽  
Probal Chatterji
Keyword(s):  
Oral Cavity ◽  
Early Stage ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Malignant Lesions ◽  
One Year

<p class="abstract"><strong>Background:</strong> Lesions of the oral cavity are very common among the general population and account for a significant number of patients in the outpatient department of otorhinolaryngology. The lesions of oral cavity can cause varied symptoms like pain, dysphagia, and difficulty in speaking. The lesions can range from simple benign conditions to life threatening malignancies.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in the department of otorhinolaryngology, Teerthanker Mahaveer Medical College and Research Centre from January 2019 till December 2019. All the 256 patients who presented to the outpatient department with lesions in the oral cavity during the given time period were included in the study after getting informed and written consent.  </p><p class="abstract"><strong>Results:</strong> Aphthous ulcers were the most common lesion (18.7%) found in this study. Buccal mucosa (50%) and anterior 2/3<sup>rd</sup> of tongue (34.3%) were the most common sites involved. Total of 204/256 (79.6%) patient had some form of addiction which included both smoked and smokeless form of tobacco as the most common type of addiction. Among the tobacco smokers, 24/80 (30%) had pre malignant and malignant lesions while among tobacco chewers 37/76 (48.6%) had pre malignant and malignant lesions.</p><p class="abstract"><strong>Conclusions:</strong> Lesions of the oral cavity are common among Indian population due to high prevalence of tobacco addiction. A thorough history taking and examination can detect premalignant and malignant lesions at an early stage, so that timely treatment can reduce the mortality rates in such patients.</p>

scholarly journals Donor defferal crietria-one year study at a tertiary care hospital

2021 ◽  
Vol 6 (2) ◽  
pp. 90-93
Author(s):  
Kirti N Vyas ◽  
Jyoti Prakash Sapre ◽  
Alpesh Maheshbhai Maru ◽  
Amar Ramkrishna Shah
Keyword(s):  
Health Care ◽  
Blood Donors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Common Cause ◽  
Common Causes ◽  
Blood Banks ◽  
One Year ◽  
Donor Deferral

: Blood Transfusion Services is vital part of health care system which saves many lives annually across the globe. Shortage of blood donors is a problem faced by all the blood banks. Many donors are deferred either due to temporary or permanent causes which differ across the blood banks.: The study was carried out on 1646 donors which came to the blood bank.: Total 194 donors were deferred out of 1646 registered donors due to different reasons, anaemia followed by intake of medicines were found to be most common causes of deferral and males were deferred more as compared to the females.: The donor deferral rate in the present study was 11.78 with anaemia as the most common cause of deferral followed by intake of medicines. The temporarily deferred donors need to be closely followed up to ensure their contribution in the blood banks after the treatment of their causes.

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