scholarly journals Pattern of admissions, clinical course and short term outcome of patients admitted to an obstetric ICU of a tertiary care hospital of north India: a retrospective study

Author(s):  
Waseeqa Nigeen ◽  
Saima Salam ◽  
Samina Ashraf ◽  
Abdus Sami Bhat

Background: Obstetric ICUs have become an important part of any tertiary care obstetric hospital. There have been studies in different parts of the world including India to determine the clinical spectrum, management and outcome of the patients admitted to these units. There have been a few studies on the subject from our part of the country, so we tried to carry out the said study. Our objective was to study indications of admissions, the pattern of complications, interventions required, and the maternal and fetal /neonatal outcome of the patients admitted in an obstetric ICU of our hospital.Methods: A retrospective descriptive study carried out at Lalla Ded hospital Srinagar, a tertiary care hospital of north India, between January 2017 and June 2017.Results: Fifty patients among 4890 obstetric admissions required ICU care giving an admission rate of 1.02%. Most of the patients fell in the age group of 26-30years (52%) followed by 31-35 years (24%).The most frequent indication for admission to ICU was pregnancy induced hypertension related eclampsia and preeclampsia which constituted about 44% (n=22) of the admissions. Obstetric haemorrhage was a close second and accounted for 34% (n=17) of the admissions. Mean ICU stay was 2.5±1 days. Four patients died giving a maternal mortality rate of 8% in this ICU. There were eleven fetal and neonatal deaths excluding ectopic pregnancy giving a fetal /neonatal mortality rate of 22%.Conclusions: Obstetric ICUs have become an important part of any tertiary care obstetric hospital. Significant number of patients get admitted and treated in these ICUs. In our part of the world majority of ICU admissions are because of eclampsia/preeclampsia and obstetric haemorrhage. Although a large number of mothers and their neonates get benefitted by way of admission to ICUs, a significant proportion of these mothers and their neonates die. There is a lot of scope of improvement in maternal and perinatal mortality. In addition to the importance of setting up of state of the art obstetric ICUs, the need for supervision of pregnancies, institutional deliveries, early detection of complications and early referral cannot be overemphasized. 

Author(s):  
Manish Munjal ◽  
Anurag Chowdhary ◽  
Harsimran Bhatti ◽  
Porshia Rishi ◽  
Nitika Tuli ◽  
...  

Background: This study evaluated the profile of ailments in patients presenting to outpatient clinic of tertiary care hospital of North India that caters to ENT diseases in population of Punjab, Haryana, Himachal Pradesh and Jammu and Kashmir.Methods: A retrospective study was undertaken by analysing the medical records of patients managed at the department of otorhinolaryngology and head and neck surgery at the tertiary care hospital, Punjab from Jan 2018 to Dec 2018 and all essential data was collected.Results: Total no. of patients presenting to the ENT OPD during the period of assesment were 32,475.  49.30% were males and 50.70 % were females, respectively. 29.70% were children below 15 years. The number of patients presenting per month were 2706, with maximum no. of patients presenting in the month of August to November. Patients with ear diseases were 9280 (28.57%), Nose diseases were 11963 (36.83%), and throat diseases were 11232 (34.58%).Conclusions: This study showed that awareness of ENT ailments and visits for specialised treatment is on the rise rather than primary level treatment at local or general medicine or family physician level.


2021 ◽  
Vol 8 (19) ◽  
pp. 1373-1379
Author(s):  
Jasmine Kaur ◽  
Navjot Kaur ◽  
Hardeep Singh Deep ◽  
Gaurav Chopra ◽  
Gurjyot Nanda

BACKGROUND Cirrhosis is a chronic disease of liver marked by degeneration of cells, inflammation and fibrous thickening of the tissue. It is a common cause of morbidity and mortality. Globally, the incidence of liver cirrhosis is on the rise. Therefore, the exact knowledge of aetiology, mode of clinical presentation, and pattern of development of complications of cirrhosis will help in optimal and costeffective control measures of this disease. We undertook this study to evaluate the cause and mode of presentation of patients with liver cirrhosis presenting in a tertiary care hospital of North India. We also wanted to determine biochemical changes in liver cirrhosis. METHODS This observational prospective study was conducted in the Department of Medicine over a period of one year, it included 122 cirrhotic patients of both sexes between 18 and 75 years irrespective of aetiology who fulfilled inclusion criteria. After detailed medical history and thorough physical examination, relevant laboratory investigations, ultrasound of abdomen, and upper GI endoscopy was done. Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease ( MELD) score was calculated. The recorded data was analysed statistically. RESULTS Out of 122 patients, 85.2 % were males and 14.8 % were females. Maximum number of patients 33.60 % were in 41 - 50 years of age. Alcohol was found to be the most common aetiological factor in 80.3 % patients. The most common presenting symptom was abdominal distension in 89.9 % patients. Various complications such as spontaneous bacterial peritonitis was present in 13.9 %, anaemia in 93.4 %, thrombocytopenia 75.4 %, deranged international normalized ratio (INR) 78.6 %, deranged renal function 45.9 %, hyponatremia in 35.2 % patients. Maximum number of patients 72.9 % were in CTP class C. 68 % patientshad MELD score > 14. CONCLUSIONS Males are mainly affected by liver cirrhosis due to excessive alcohol consumption therefore proper preventive measures have to be taken. The raised total leucocyte count (TLC), serum bilirubin, serum creatinine, decreased serum albumin, serum sodium and coagulopathy were found to be poor prognostic markers. KEYWORDS Cirrhosis, Aetiology, Complications, Prognosis


Author(s):  
Abhilasha Williams ◽  
Anuradha Bhatia ◽  
EmyAbi Thomas ◽  
Clarence J Samuel

2020 ◽  
pp. 004947552098245
Author(s):  
Pooja Kumari ◽  
Priya Datta ◽  
Satinder Gombar ◽  
Deepak Sharma ◽  
Jagdish Chander

The aim of our study was to determine the incidence, microbiological profile, risk factors and outcomes of patients diagnosed with ventilator-associated events in our tertiary care hospital. In this prospective study, intensive care patients put on mechanical ventilation for >48 h were enrolled and monitored daily for ventilator-associated event according to Disease Centre Control guidelines. A ventilator-associated event developed in 33/250 (13.2%); its incidence was 3.5/100 mechanical ventilation days. The device utilisation rate was 0.86, 36.4% of patients had early and 63.6% late-onset ventilator-associated pneumonia whose most common causative pathogen was Acinetobacter sp. (63.6%). Various factors were significantly associated with a ventilator-associated event: male gender, COPD, smoking, >2 underlying diseases, chronic kidney disease and elevated acute physiological and chronic health evaluation II scores. Therefore, stringent implementation of infection control measures is necessary to control ventilator-associated pneumonia in critical care units.


Author(s):  
Yan-Jun Zheng ◽  
Ting Xie ◽  
Lin Wu ◽  
Xiao-Ying Liu ◽  
Ling Zhu ◽  
...  

Abstract Background The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. Methods All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. Results Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not. Conclusions The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.


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