scholarly journals Unscarred uterine rupture: a retrospective analysis in tertiary center

Author(s):  
Madhureema Verma ◽  
Radheshyam Bairwa

Background: Uterine rupture is a catastrophic obstetrical emergency associated with a significant fetomaternal morbidity and mortality. Many risk factors for uterine rupture, as well as a wide range of clinical presentations have been identified. The objectives of the present study were to analyze the frequency, predisposing factors, maternal and fetal outcomes of unscarred uterine rupture.Methods: A retrospective analysis of cases of unscarred uterine rupture was conducted at the Department of Obstetrics and Gynaecology Jhalawar medical college Jhalawar Rajasthan from January 2009 to December 2016.Results: Our analysis comprised of 11 cases with unscarred uterine rupture. Incidence of unscarred uterine rupture is 0.01% or 1/10,000  deliveries.Conclusions: In our study there was no history of uterine scarring so the main predisposing factor are maltiparity and obstructed labour. The grand multiparas women and obstructed labour must be managed by proper trained personnel and in tertiary care center in order to avoid the morbidity and mortality.

Author(s):  
P. Sivayadevi ◽  
Heber Anandan

<p class="abstract"><strong>Background:</strong> Syphilis presents with a wide range of mucocutaneous and systemic manifestations, which can mimic many other diseases. The pattern of acquired syphilis is changing in recent years because of widespread use of antibiotics and HIV infection which leads to under diagnosis. Aim was to study the demographic factors and changing pattern of clinical features of acquired syphilis.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of all cases of sexually transmitted infections registered in the Department of Venereology, Thanjavur Medical College from January 2013 to December 2017 was done. The data regarding epidemiological, clinical and investigational details were recorded and analyzed for changing trends in incidence, pattern and clinical presentation of syphilis.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of the total 14,672 cases attended theSTI clinic, 140 patients were diagnosed as having syphilis. There were 101 (79.4%) males and 39 (27.8%) females. Primary Syphilis was diagnosed in 18 (12.25%), Secondary syphilis in 38 (27.14%) and latent in 84 (60%) cases. Palmoplantar syphilide was the most common skin manifestation seen in 20 (52.63%) cases of secondary syphilis. 11 (7.85%) patients was human immunodeficiency virus (HIV) reactive.</p><p class="abstract"><strong>Conclusions:</strong> Our study indicates an increasing trend in the prevalence of syphilis cases in last 5 years with a rise in early symptomatic syphilis demanding steps to increase awareness among the general population.</p>


Author(s):  
B. B. Yadav ◽  
S. B. Yadav ◽  
P. K. Damase

Background: To highlight common pattern of congenital malformation seen at hospital population of tertiary care center in Maharashtra.Methods: The study was a descriptive prospective study and conducted in the department of obstetrics and gynaecology of government medical college Latur, Maharashtra for a period of six months. Study includes all womens coming for 2nd trimester MTP due to congenital anomalies in foetus and women’s admitted in labour having anomalous foetus. Details of maternal age, parity, type of anomaly present and sex of fetus were noted.Results: Total babies born in the study period were 3482 (including the second trimester abortions). Total babies with congenital abnormality were 75, making the prevalence 2.15%. 10 cases (13.33) had multiple anomalies involving more than one system. The predominant system involved was central nervous system 40 (53.33%) followed by gastrointestinal system 15 (20%). In this study male babies affected more than females.Conclusions: Prevalence of the congenital anomalies will be definitely higher at tertiary care center and to know prevalence in community, more community based studies are required. Increased awareness about preventable risk factors may help in reducing the incidence of congenital anomalies.


Author(s):  
Neeta Chaudhary ◽  
Natasha Tyagi ◽  
Smita Tyagi ◽  
G. S. Manchanda ◽  
Malvika .

Background: This is a study of rational use of blood transfusion in a tertiary care center. So, this study was done to find out the indications of blood transfusion in department of obstetrics and gynaecology and measures to minimize the requirement of blood transfusion to reduce maternal mortality and morbidity.Methods: This is a retrospective study in department of obstetrics and gynaecologyin Muzaffarnagar Medical College, Muzaffarnagar, U.P. in collaboration with the department of pathology including blood bank for the duration of 1 year i.e. 1st January, 2017 to 31st December, 2017.  Total transfusions in 1 year were 706 of which 406 were in obstetrics and 300 were in gynecology.Results: In our study maximum 16.20% blood transfusions were given during cesarean section in third trimester in unbooked cases who came with severe anemia in labour. Others were APH (12%) and abortions (13.05%). This shows that anemia is still a major cause of maternal mortality and morbidity in India. In Gynecological cases blood transfusion was more in third parity and above indicating that perimenopausal women were also more susceptible for anemia due to disease of perimenopausal age group like AUB and fibroid.Conclusions: Maximum number of transfusions specially PRBC in obstetrics were of moderate to severe anemia, mainly to the patients who were term or in labor and of high-risk pregnancies, who were unbooked with no antenatal care. In Gynecology cases, blood transfusion was of perimenopausal or menopausal group with moderate anemia. This comes to the conclusion that all preventive measures should be taken in females from womb to tomb to correct anemia and this will indirectly help to prevent maternal and perinatal morbidity and mortality.


Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Aqeela J. Madan ◽  
Fayza Haider ◽  
Saeed Alhindi

Abstract Background Intussusception is the most frequent cause of bowel obstruction in infants and toddlers; idiopathic intussusception occurs predominantly under the age of 3 and is rare after the age of 6 years; the highest incidence occurs in infants between 4 and 9 months; the gold standard for treatment of intussusception is non-operative reduction. This research will tackle the problem of pediatric intussusception in our center which is the largest tertiary center in our region. The primary outcome is to study the profile of intussusception; the secondary outcome is to assess the success rate of pneumatic reduction in the center’s pediatric population as well as to study the seasonal variation if present. Results During the study period, eighty-six (N=86) cases were identified, from which 10 cases were recurrent intussusception. Seventy-six (N=76) cases were included from the study period. N=68 (89%) were less than 3 years of age, and only N=2 (3%) were above 6 years. Seasonal variation was not significant; N=69 (91%) patients had successful pneumatic reduction under fluoroscopy while thirteen patients N=13 (17%) needed operative intervention. Conclusion Ileocolic intussusception is one of the most common pediatric surgical emergencies that can be successfully managed non-operatively in our institute; 89% of the cases were below 3 years of age, and no seasonal variation was demonstrated. Operative intervention was required in 13 cases with the main reason being lead point. The fact that the pediatric surgeon performs the reduction might have contributed to a high success rate reaching 91% in our center. This study provides a valuable opportunity for future regional data comparisons and pooled data analyses.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Laurenz T. Fischer ◽  
Daniel A. Hochfellner ◽  
Lisa Knoll ◽  
Tina Pöttler ◽  
Julia K. Mader ◽  
...  

Abstract Background The lipid-lowering and positive cardiovascular effect of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors was shown in several studies, hence, they are more widely used in the lipid-lowering management of individuals with high cardiovascular risk. As real-world data are still scarce, specifically in patients with type 2 diabetes (T2D), the aim of this retrospective analysis was to investigate the efficacy of PCSK9 inhibitors in lowering low-density lipoprotein cholesterol (LDL-C) in an outpatient clinic of a tertiary care center in routine care. Methods A retrospective analysis of data extracted from the electronic patient record was performed. Patients who were routinely prescribed with PCSK9 inhibitor therapy (alirocumab or evolocumab) during the years 2016 and 2019 were included in the analysis. Characteristics of the patient population, the effects on LDL-C and HbA1c levels as well as subsequent cardiovascular events were assessed over an observation period of 18 months. Results We identified 237 patients treated with PCSK9 inhibitors between January 2016 and September 2019. Almost all patients (97.5%) received PCSK9 inhibitors for secondary prevention. 26.2% of the population had a concomitant diabetes diagnosis. Intolerance to statins (83.1%), ezetimibe (44.7%) or both agents (42.6%) was reported frequently. Three months after initiation of PCSK9 inhibitor therapy, 61.2% of the patients achieved LDL-C levels < 70 mg/dl, and 44.1% LDL-C levels < 55 mg/dl. The median LDL-C was lowered from 141 mg/dl at baseline, to 60 mg/dl after 3 months and 66 mg/dl after 12 months indicating a reduction of LDL-C as follows: 57.5% after 3 months and 53.6% after 12 months. After 3 months of observation, target achievement of LDL-C was higher in patients with T2D compared to non-diabetes patients; < 55 mg/dl: 51% vs. 41.5%; < 70 mg/dl 69.4 vs. 58.5%. After 12 months even more pronounced target LDL achievement in T2D was demonstrated < 55 mg/dl: 58.8% vs. 30.1%; < 70 mg/dl 70.6 vs. 49.6%. Patients with insufficiently controlled T2D (HbA1c > 54 mmol/mol) had a higher reduction in LDL-C but still were more likely to subsequent cardiovascular events. Conclusions Significant reductions in LDL-C and a high percentage of patients achieving recommended treatment targets were observed. The percentage of patients with T2D meeting recommended LDL-C targets was higher than in those without T2D. Still some patients did not achieve LDL-C levels as recommended in current guidelines. Special attention to the characteristics of these patients is required in the future to enable achievement of treatment goals and avoid adverse cardiovascular outcomes.


Thyroid ◽  
2007 ◽  
Vol 17 (6) ◽  
pp. 549-556 ◽  
Author(s):  
Simona Grozinsky-Glasberg ◽  
Carlos A. Benbassat ◽  
Gloria Tsvetov ◽  
Rafael Feinmesser ◽  
Hava Peretz ◽  
...  

2020 ◽  
Vol 7 (01) ◽  
pp. 4721-4725
Author(s):  
Dr. Sanjeev Kumar Singh ◽  
Dr. Geeta Maurya ◽  
Dr. Pinki Pandey ◽  
Dr. Rashmi

Background: Breast tumours are very common cause of morbidity and mortality worldwide specially in developing countries. Breast lesions show broad spectrum of disease patterns in respect to benign, malignant, and non-neoplastic. Breast cancer is one of the most frequently occurring cancer among women. Objective: To study the frequency, age distribution, clinical and histological patterns of neoplastic and non-neoplastic lesions of breast in this rural population. Material and methods: This observational study was conducted over a duration of three years. In which we studied 210 cases of breast lesions. Specimens were received in department of pathology. Grossing, tissue processing, staining done according to standard protocol. Haematoxylin and eosin (H&E) stained sections were examined under microscope to categorise different type of lesions in the form of non-neoplastic and neoplastic. Results:  Out of 210 breast lesions, fibroadenoma was the commonest (114 cases) benign lesion. While invasive ductal carcinoma (70 cases) was commonest in malignant category. Non neoplastic lesions stand on third place, study showed 6 cases out of 210 total cases, in which acute mastitis (4 cases) was most common. Benign tumours were mostly seen in 2nd and 3rd decade and malignant tumour mainly in 5th and 6th decade Conclusion: Early histopathological diagnosis of breast lesions is very important to differentiate between benign and malignant lesions. Large number of cases of invasive ductal carcinoma (>33% of all cases) were seen in our study, which is a serious concern. So, generation of awareness among women is need of time to reduce the morbidity and mortality specially in Indian rural setup


Author(s):  
Abu Hasan Sarkar ◽  
Bishnu Ram Das

Background: Japanese encephalitis (JE) is of particular interest as it has a high morbidity and mortality. Neurological sequale is the most dreaded damage caused by JE. It is a preventable disease with specific interventions. The objective of the study was to study the demography, clinical profile and outcome of patients with Japanese Encephalitis admitted to the wards of Internal Medicine and Pediatrics at Jorhat Medical College Hospital.Methods: Hospital based observational study for one year in Jorhat Medical College, Jorhat, Assam.Results: The mean age for JE was 32.25±27 years for male, 27.47±22 years for female and 29.94±24 years overall. Assessment of clinical signs and symptoms showed that fever and change in mental status were present in 100% of JE cases followed by neck rigidity in 79.3% and headache in 68.9%. 44.8% of JE cases had history of seizure, 37.9% had vomiting, 34.5% had irritability, 13.8% were unconscious. The peak of JE incidence occurred in the month of July (77.6%). Complete recovery was seen in 39.2%, followed by death in 32.6% and recovery with neurological sequalae in 28.2% at the time of discharge.Conclusions: Vigorous awareness activities should be carried out to sensitize people on prevention of JE. 


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