scholarly journals Instrumental delivery: a comparative study in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1079
Author(s):  
Bhanu B. T. ◽  
Anitha G. S.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Care Hospital ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Maternal And Neonatal Outcomes ◽  
Vertex Presentation

Background: To compare maternal and neonatal outcomes of vacuum versus forceps application in assisted vaginal delivery.Methods: Women in labor with vertex presentation were delivered by indicated/propylactic vacuum or forceps. A total of 500 cases were included in this retrospective study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum hemorrhage, Apgar score, neonatal jaundice, perinatal mortality, NICU admissions etc. Chi square test was used to analyze the data.Results: Maternal morbidity was significant in the forceps group. With regards to neonatal morbidity, in NICU admissions, statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the modern obstetrics. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother and decrease NICU admissions.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

scholarly journals EARLIEST SYMPTOMS OF PRESENTATION IN COVID-19 PATIENTS IN TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S500-03
Author(s):  
Maqbool Raza ◽  
Muhammad Ali Raza ◽  
De Emmal Asjad Cheema ◽  
Maham Asjad Cheema ◽  
Atif Rafique ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Sampling Technique ◽  
Military Hospital ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Significant Difference ◽  
Chi Square Test

Objective: To determine the frequency of earliest symptoms of COVID-19 infection among patients with confirmed SARSCOVID-19 infection. Study Design: Cross-sectional analytical study. Place and Duration of Study: Combined Military Hospital Multan, from Jun to Dec 2021. Methodology: Data from 299 patients admitted in tertiary care settings was collected on a questionnaire. Patients regardless of gender and age who had confirmed COVID-19 infection through Real Time Polymerase Chain Reaction (RT-PCR) were included in the study. A nonprobability consecutive sampling technique was used to select samples. Data was entered and analyzed through SPSS version 22. Frequencies and percentages of various presenting symptoms were calculated. Sample size calculated at 95% level of confidence, 1% required precision, and 27% anticipated population proportion were 299. The overall difference in frequencies of symptoms in various groups was compared by using chi-square test. p-value <0.05 was taken as significant. Results: A total of 299 participants were included in this analysis. The median age for participants (interquartile range [IQR]) was 46 (36-54) years. Among 299 adults the reported symptoms were cough 238 (79.6%), fever 176 (58.7%) and, dyspnea 113 (37.8%). Only 78 (26.1%) of participants with confirmed infection reported having all three symptoms of cough, fever, and dyspnea. Other reported symptoms in patients were diarrhea 54 (18.1%), fatigue 128 (42.8%), myalgia 113 (37.8%), and anosmia 98 (32.8%). There was no significant difference in the frequency of symptoms across both genders. Conclusion: The most frequent symptoms of COVID-19 are cough, fever, and dyspnea.

scholarly journals Viral clearance in COVID-19 patients admitted in designated COVID hospital in Western India

2021 ◽  
Vol 8 (9) ◽  
pp. 4303
Author(s):  
Harpreet Singh ◽  
Kanwaljit Kaur ◽  
S. K. Ghai ◽  
Pranaya Gurmeet ◽  
Raju Agarwal ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Viral Clearance ◽  
Care Hospital ◽  
Sectional Study ◽  
Rt Pcr ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
Chi Square Test

Background: COVID-19 pandemic is one of the greatest challenges faced worldwide and has not only posed health crisis but also had social, economic and political devastating effects. The speedy transmission risk enforced bygone practices of quarantine of healthy persons and isolation of all positive patients. The basis of all key policy making is the understanding of virus clearance from the body so that transmission can be ceased. The aim of the study was to understand the viral clearance and its’ co-relates for guiding infection control and transmission practices in COVID-19.Methods: Cross sectional study in a tertiary care hospital. A cross-sectional study of total 398 patients admitted for COVID-19 between June 2020 and November 2020 at a tertiary care centre. Statistical analysis used: frequency, percentage, and chi square test Chi square test for linear trend and was used to find association.Results: 88.19% were males and 11.81% were female patients, mean age of study participants was 34.84 years. 61.56% were symptomatic and among them 1.64% presented with severe symptoms. Mean duration to turn RT-PCR negative was 11.83 days. No significant difference in time taken to turn RT-PCR negative among asymptomatic and symptomatic cases is suggestive of no difference in viral load and its clearance in symptomatic vs asymptomatic cases.Conclusions: The disease profile of COVID-19 in our setup was alike the national disease profile and the recovery rate being 98.76%. Presence of co-morbidities affects viral clearance in COVID-19.

scholarly journals Feto-maternal outcomes following labor induction at a tertiary care center

2020 ◽  
Vol 10 (2) ◽  
pp. 29-32
Author(s):  
Upendra Pandit ◽  
Basant Sharma ◽  
Rakshya Joshi ◽  
Julli Chaudhari ◽  
Prekshya Singh ◽  
...  
Keyword(s):  
Apgar Score ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Labor Induction ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test

Background: Labor induction is one of the most common Obstetrics interventions worldwide. It has got significant risks and benefits. Careful selection of cases for induction improves the feto­maternal outcomes. So, the study was designed to assess the fetomaternal outcome and factors associated with mode of delivery following the induction of labor. Methods: It was a descriptive observational study conducted in the department of Obstetrics and Gynecology from July 17, 2018, to July 16, 2019. The study comprised of 264 mothers admitted in the labor ward subjected to labor induction as clinical management of labor and delivery. Data analyzed with chi-square test and one-way analysis of variance (ANOVA) wherever appropriate. Results: Of 2950 deliveries, the induction rate was 8.94%. Out of them, 264 mothers undergone labor induction. A caesarean was the highly associated mode of deliveries 168(63.63%) due to in­duction failure 94(55.97%) followed by fetal distress 37(22%). The mean birth weight of neonates was 3.09±0.41 kg. Apgar score in one minute and hospital stay showed a significant difference (p-value .002), in modes of deliveries. No significant association was observed in maternal and fetal complications like PPH, endometritis, and low Apgar score <7 in five minutes. The majority of neonates admitted for observation at the care unit. The neonatal mortality was two. Conclusions: Caesarean mode of delivery highly was associated with labor induction due to in­duction failure and fetal distress. Carefully selected cases improve morbidity and fetomaternal outcomes following labor induction.

scholarly journals Comparative study of maternal and foetal outcome in instrumental vaginal deliveries

2017 ◽  
Vol 6 (11) ◽  
pp. 4945
Author(s):  
Mariyam S. Ahmed ◽  
Anand N. Bhalerao
Keyword(s):  
Post Partum ◽  
Neonatal Morbidity ◽  
Chi Square ◽  
Perineal Tears ◽  
Vacuum Device ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Chi Square Test ◽  
Foetal Outcome ◽  
Labour Room

Background: The art of instrumental vaginal delivery is fading as more and more obstetricians resort to caesarean sections. Instrumental deliveries are deliveries accomplished with the use of vacuum device or forceps. Once either is applied to the foetal head, outward traction generates forces that augment maternal pushing to deliver the foetus vaginally. Objective of present study was to compare the maternal and foetal outcome of forceps versus ventouse delivery.Methods: It was a prospective observational study conducted in Sassoon Hospital between January 2014 to January 2015. A total of 120 cases, 60 each of forceps and ventouse, admitted in labour room were included in the study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum haemorrhage, Apgar score, instrumental injuries. Chi square test and z test of proportion was used to analyze the data.Results: Maternal morbidity, namely episiotomy extension as well as perineal tears were significant in the forceps group. With regards to neonatal morbidity, no statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the armamentarium of the modern obstetrician. However, ventouse may be chosen first (if there is no foetal distress) as it is significantly less likely to injure the mother.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Study on Maternal and Neonatal Outcome of women undergoing Caesarean Section using Nice Classification in a Tertiary Care Hospital in Rural Area of Central India - An Observational Prospective Study

2021 ◽  
Vol 17 ◽  
Author(s):  
Shuchi M. Jain ◽  
Ketki. Thool ◽  
Manish A. Jain ◽  
Poonam V. Shivkumar
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Neonatal Outcome ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Central India ◽  
Neonatal Morbidity ◽  
Bladder Injury ◽  
Care Hospital ◽  
Chi Square

Background : Caesarean section is often perceived to be safer than vaginal delivery for mothers and neonates, and thus has become increasingly common around the globe. However, it may actually be detrimental to maternal and neonatal health while consuming valuable resources. Objective : The objective of this study was to categorize the caesarean sections performed in our rural institute into various categories using NICE classification and to study the maternal and neonatal outcome in them. Method : This was a prospective study of all women who underwent caesarean section over a period of 18 months. Data was retrieved from the files of women for morbiditiy and mortality in mothers and babies. Data was entered in MS excel sheet and analyzed with percentages and chi square test using SPSS ver.17. Results: Caesarean section rate (CSR) was 36.88%. All CS were classified into four categories based on urgency as per NICE guidelines. There were 22.62% women in Category I, 38.61% in category II, 28.37% in category III and 10.40% in Category IV. Adhesions, extension of angle, lacerations in lower segment, scar dehiscence, atonic PPH and bladder injury were noted in (12.83%), 11.81%, 6.83%, 4.08% , 1.53% and 0.08% CS respectively. Caesarean hysterectomy was done in 0.24% cases. Postoperative morbidity was febrile morbidity (11.93%), postdural puncture headache (13.85%), paralytic ileus (11.49%), wound infection (8.83%), ARDS (0.70%), sepsis (0.78%), pulmonary edema (0.47%) and pulmonary embolism (0.03%). Maternal mortality was 0.03%. Neonates born were 2577 (29 were twin deliveries). 82.46% neonates were healthy, 16.80% had morbidities and 0.74% were still born. Apgar score of less than 7 was in 10%. 16.80% neonates were admitted in NICU during their hospital stay. Neonatal mortality was 1.47%. Conclusion : Intraoperative and post-operative complication were more in caesarean sections of category I and II as compared to category III and category IV. Neonatal morbidity, mortality and admissions to NICU were more in caesarean sections of category I and II as compared to category III and category IV. Thus though caesarean section is an emergency lifesaving procedure for mother and baby it may prove detrimental to their health.

Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

scholarly journals Frequency of Depression in Burn Patients at a Tertiary Care Hospital

2020 ◽  
Vol 11 (3) ◽  
pp. 3-7
Keyword(s):  
Tertiary Care ◽  
Depression Scale ◽  
Care Hospital ◽  
Burn Patients ◽  
Chi Square ◽  
Cross Sectional ◽  
Residential Status ◽  
Duration Of Illness ◽  
Chi Square Test ◽  
Medical University

Background: Burns are physically, psychologically and economically challenging injuries and the factors leading to them are many and under studied. Different studies have associated burn injuries with psychiatric disorders from different parts of the world. Objective: To determine the frequency of depression among the burn patients. Methodology: This cross sectional study was conducted at the Pak Italian Modern Burn Unit, Nishtar Medical University, Multan and the Department of Psychiatry, Nishtar Medical University, Multan. Non probability consecutive sampling technique was used to collect the data from study subjects, which consisted of 150 patients of burn. All patients were assessed by a single psychiatrist on Hospital Anxiety and Depression scale (HADS) scale for screening of depression. Chi square test was applied to determine association between the socio demographic factors of burn patients and depression. Results; Of these 150 study cases, 91 (60.7 %) were male patients while 59 (39.3 %) were female patients. Mean age of our study cases was 33.94 ± 8.88 years. The frequency of depression was noted as 88 (58.7%). Post stratification Pearson chi square test revealed significant associations between age (p=0.001), residential status (p=0.038), occupation (p= 0.000), etiology of burn (p=0.044) and duration of illness (p=0.000) with depression. Conclusion: A high frequency of depression was noted among burn patients in our study. Depression was significantly associated with age, residential status, occupation, duration of illness and etiology of the burn. Healthcare professionals treating such patients should anticipate depressive symptoms in these patients and treat them accordingly.

scholarly journals Trends of caesarean section: an analytical overview of indications

2019 ◽  
Vol 9 (1) ◽  
pp. 288
Author(s):  
Shruti A. Gavhane ◽  
Shilpa N. Chaudhari
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Graphical Representation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Chi Square Test ◽  
Evidenced Based

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.

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