scholarly journals Obstetric hysterectomy: analysis of 50 cases at a tertiary care hospital

2018 ◽  
Vol 7 (7) ◽  
pp. 2882
Author(s):  
Niranjan M. Mayadeo ◽  
Girija Swaminathan
Keyword(s):  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Hypovolemic Shock ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Medical Sciences ◽  
Institutional Ethics ◽  
Adherent Placenta ◽  
Obstetrics And Gynaecology ◽  
Increased Risk

Background: Despite advances in modern medical sciences, there is a plethora of morbidity which continues to affect women during childbirth, necessitating removal of the uterus in the peripartum or postpartum period. This study analyses 50 cases of obstetric hysterectomy done in a single institute.Methods: After Institutional Ethics Committee approval, a retro prospective analysis of hospital records of 50 cases of obstetric hysterectomy was done over a five year period in the department of obstetrics and gynaecology at a tertiary care referral centre-KEM hospital.Results: During the study period, there were 50 cases of obstetric hysterectomy out of 43839 deliveries giving an incidence of 0.12%. Mean age of women undergoing obstetric hysterectomy was 29.9 years. 86% of these were multiparous. The most common indication was morbidly adherent placenta (38%) followed closely by followed by rupture uterus (34%) and uterine atony (20%). Total hysterectomy was the most preferred type of hysterectomy (74%). Urinary tract injury and hypovolemic shock were the most frequently encountered complications. The maternal mortality rate in our study was 4%. 86% of the babies born had Apgar score of 9/10. 44% of babies required admission to neonatal intensive care unit.19.6% of the patients had still born babies and there were 4 neonatal deaths.Conclusions: Obstetric hysterectomy is associated with increased risk of maternal and perinatal morbidity and mortality.

scholarly journals Epidemiological study of herpes zoster in a tertiary care hospital

2017 ◽  
Vol 5 (10) ◽  
pp. 4550
Author(s):  
Nekram Baghel ◽  
Sankalp Awasthi ◽  
Sweta S. Kumar
Keyword(s):  
Herpes Zoster ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Clinical Problem ◽  
Care Hospital ◽  
Post Herpetic Neuralgia ◽  
Medical Sciences ◽  
Dermatology Department ◽  
Varicella Zoster ◽  
Increased Risk

Background: Herpes Zoster, which presents as a localized, painful cutaneous eruption is a common clinical problem, caused by reactivation of latent Varicella Zoster Virus (VZV) and is usually self- limiting in healthy adults. In this era of HIV infection, HIV seropositive patients are at increased risk of severe or disseminated cutaneous or visceral involvement. Aim was to analyse the clinical pattern and epidemiological factors of Herpes Zoster and to know the HIV prevalence among patients with Herpes Zoster.Methods: A total of 110 patients with Herpes Zoster attending dermatology department at Uttar Pradesh university of medical sciences (UPUMS), Saifai, Etawah, India from a period of July 2015 to July 2017 were included in the study.Results: Out of 110 patients, 79 were males 31 were females. Age group varied from 8-80 years. Most common dermatomes involved were thoracic followed by ophthalmic division of trigeminal nerve. 33.6% of patients showed HIV seropositivity. Most commonly observed complication was post herpetic neuralgia which was encountered in 36% of the patients and most of these patients were above the age of 60 years. Post herpetic neuralgia was more commonly seen in seropositive individuals as compared to seronegative individuals.Conclusions: Disseminated zoster and multi-dermatomal involvement were encountered in immuno-compromised individuals. Post herpetic neuralgia was seen in elderly patients, especially in case of ophthalmic zoster. 

scholarly journals Incidence and determinant of eclampsia and its associated complication in tertiary care hospital of Gujarat

2019 ◽  
Vol 9 (1) ◽  
pp. 221
Author(s):  
Chirag Banker ◽  
Latika Mehta
Keyword(s):  
Sampling Method ◽  
Tertiary Care Hospital ◽  
Economic Status ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Obstetrics And Gynaecology ◽  
Antenatal Visits

Background: Eclampsia is one of common cause of maternal mortality in developing country like India. It can be detected and prevented if early ANC care is properly done. Mainstay of management in case of eclampsia is early delivery to improve the prognosis in terms of reducing maternal and perinatal morbidity and mortality.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, at tertiary care centre in the state of Gujarat, for a period of two years from July 2012 to June 2014. With purposive sampling method all patients admitted with complain of eclampsia is included in study. Details are taken in predesigned, pre-validated and prescribed proforma.Results: Hospital based incidence of eclampsia in our study is 1.11%. Majority of the patient were unbooked. Eclampsia is a disease of young primigravida, specifically teenage primigravida. Seventy-five percentage of eclampsia cases occurred in the antenatal period, 14% in intranatal period and 11% in the postnatal period.Conclusions: In developing countries like India still eclampsia is major problem. Good antenatal care with increased antenatal visits may help in reducing the incidence. Increased incidence among young primigravida and low socio-economic status group provides the target group for medical measures.

scholarly journals Clinico epidemiological study of thermal burns in a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 759
Author(s):  
Ravikumar G. ◽  
Shanmugapriya P. ◽  
Sugapradha G. R. ◽  
Senthamilselvi R.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hypovolemic Shock ◽  
Burn Injuries ◽  
Care Hospital ◽  
Burn Patients ◽  
Increased Risk ◽  
First Aid Training ◽  
Mortality Ratio ◽  
The Mean

Background: Substantial number of people suffers from burn injuries every year in India that make the patients endure disease, surgeries and years of rehabilitation. The higher mortality and prolonged morbidity results in heavy social, economic and clinical burden to the nation. The objective was to study and analyse the socio-demographic profile of burn patients in addition to evaluate the causes, manner and clinical course of burn patients along with its outcome.Methods: This was a registry based retrospective study on 114 burns patients, admitted in a Tertiary Care Hospital in South India from January 2018 to June 2018. Data were collected and assimilated comprehensively.Results: The age group of patients ranged from 13-70 years, the mean age being 29 years. The overall male, female to transgender ratio was 0.57:1:0.01. Most of the patients were married (66.66%). The TBSA involvement in burns ranged from 10% to 100% and the mean TBSA was found to be 11.4±2.95. A higher TBSA involvement is associated with an increased risk of mortality and this association between TBSA and mortality was found to be statistically significant (p<0.05). Mortality ratio in this study was 51.75% and septic shock (58%) was the most common cause of death followed by hypovolemic shock (42%).Conclusions: Burns are one of the leading causes of preventable morbidity and mortality, provided the prevention strategies address the hazards of specific burn injuries, awareness education for vulnerable population and targeted first aid training. 

scholarly journals A study of etiology and role of bacteria in the pigment gall stone diseases at a tertiary care hospital

2018 ◽  
Vol 5 (12) ◽  
pp. 4022
Author(s):  
Rajendra Desai ◽  
Earnest Daniel Prasad ◽  
Satyanarayana G. ◽  
Lakshmi V. ◽  
Nayana Joshi
Keyword(s):  
Tertiary Care ◽  
Gall Stone ◽  
Biliary Colic ◽  
Care Hospital ◽  
Medical Sciences ◽  
Institutional Ethics ◽  
Gall Stones ◽  
Calculus Disease ◽  
Significant Health

Background: Calculus disease of the biliary tract continues to be a significant health problem. Pigment stones are more common in Eastern studies. Predisposing factors such as cirrhosis, ileal resection are commonly seen in the West; while infection as a cause predominates in South East Asia. In this study we prospectively studied Pigment gall stones to examine the causes for and the role of bacteria in pigment Gall stone diseaseMethods: A hospital based prospective study was carried out from January 1992 to December 1994 at Nizam’s Institute of Medical Sciences, Hyderabad. Institutional Ethics Committee permission was taken. Informed consent was obtained from all selected patients. During the study period a total of 25 consecutive patients with Pigment gall stones were analyzed. Details were recorded in a proforma. Stones were collected from the Gall Bladder with aseptic precautions.Results: Total of 25 patients included, wherein 13 (52%) males and 12 (48%) females. The Median age was 55.5 years and the mean age was 50.2 years. Of 25 patients 11 (44%) had black pigment stones and 14 (56%) had brown stones. 22 (88%) patients presented with biliary colic, and 8 (32%) presented with chronic cholecystitis. At surgery 14 (56%) had a thickened wall suggesting inflammation, 7 (28%) had edema. Bile culture was positive in 11 (44%) patients and stone culture in 5 (20%) patient. Twenty two of 25 patients (88%) had evidence of bacteria on electron microscopy.Conclusions: Whether black stones are associated with higher infection rates or bacteria cause black stones – this question probably would never be answered either on the bench or in the clinicians ward. We, however, can definitely say they are intimately related.

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)

63 Characterizing Organizational Risk Factors and Clinical Impacts of Unplanned Extubations among Infants in the Neonatal Intensive Care Unit

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e44-e45
Author(s):  
Gabriella Le Blanc ◽  
Elias Jabbour ◽  
Sharina Patel ◽  
Marco Zeid ◽  
Wissam Shalish ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Organizational Factors ◽  
Subject Area ◽  
Administrative Databases ◽  
Perinatal Medicine ◽  
Unplanned Extubations ◽  
Increased Risk

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Organizational factors in neonatal intensive care units (NICUs) can increase the risk of adverse events, such as unplanned extubations (UPEs). UPE is the premature and unanticipated removal of an endotracheal tube. UPE and subsequent reintubation may increase the risk for lung injury and bronchopulmonary dysplasia (BPD) among preterm infants. Objectives First, we aimed to assess the association between daily nursing overtime and UPEs in the NICU. Second, we aimed to evaluate the association between UPE, re-intubation after UPE, and BPD in the sub-group of infants born &lt; 29 weeks’ gestational age (GA). Design/Methods We conducted a retrospective cohort study including infants admitted to a tertiary care NICU between 2016-2019. Daily nursing hours were obtained from local administrative databases. Patient data was collected from the local Canadian Neonatal Network database. Association between ratio of daily nursing overtime hours/total nursing hours (OTR) was compared between days with and without UPEs, using logistic regression analyses. Associations between UPE and BPD among infants born &lt;29 weeks requiring mechanical ventilation was evaluated in a 1:1 propensity-score matched (PSM) cohort. Infants were matched based on GA ± 2 weeks, mechanical ventilation days at time of UPE ± 5 days and SNAPII&gt;20. Results There were 108/1370 (7.8%) days with ≥ 1 UPE, for a total of 116 UPE events from 87 patients (23-42 weeks GA). Higher median OTR was observed on days with UPE compared to days without (3.3% vs. 2.5%, p=0.01). OTR was associated with higher adjusted odds of UPE (aOR 1.09, 95% CI 1.01-1.18), while other organizational variables were not (Table 1). Among ventilated infants &lt;29 weeks’ GA (n=XX), UPE rate was 31% (59), BPD rate was 42% (81) and re-intubation rate after UPE was 59% (35). In the PSM cohort of infants &lt;29 weeks, re-intubation after UPE, was associated with increased length of mechanical ventilation (aOR 16.45; CI 6.18, 26.72) as well as increased odds of BPD, when compared to infants not requiring re-intubation (aOR 4.97, 95% CI 1.54-18.27) (Table 2). Conclusion Higher nursing overtime was associated with increased UPEs in the NICU. Re-intubation was frequently required after a UPE. Among the infants born &lt; 29 weeks’ GA, UPE requiring reintubation was associated with increased total length of mechanical ventilation and increased risk of BPD. Our findings highlight the role of workforce management in improving outcomes in the NICU, through reducing the incidence of UPEs.

scholarly journals Awareness and acceptance of contraceptives among the mothers of infants attending an immunization session at a field practices area of a tertiary care hospital

2018 ◽  
Vol 6 (1) ◽  
pp. 374
Author(s):  
S. B. Gupta ◽  
Meenakshi Singh ◽  
Atul Kr. Singh ◽  
Huma Khan ◽  
Alpana Saxena
Keyword(s):  
Health Workers ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Sciences ◽  
Postpartum Contraception ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Contraceptive Measure ◽  
One Year ◽  
Type Of Delivery

Background: India was the first country in the world to have launched a National Programme for Family Planning.Methods: A cross-sectional descriptive study was carried out in the in Vaccination unit of rural field practice area of Shri Ram Murti Smarak institute of Medical Sciences (SRMSIMS) Bareilly (U.P). Objective of the study was to assess knowledge and practice of postpartum contraception and factors affecting the usage of contraceptives in Rural area. All females who delivered within last one year were included in the study. A pre-structured questionnaire was used. A total of 98 females were included. The appropriate statistical analysis was done to present the results.Results: 28.57% females had adopted one or the other postpartum contraceptive measure. Condom was the most common method used. Usage of postpartum contraception was significantly associated with women’s and husband’s education, type of delivery and availing of antenatal and postnatal visits.Conclusions: Overall usage of postpartum contraception was low there is need to focus at every step to contact of these women with health facility or health workers.

scholarly journals A questionnaire based study on the knowledge, attitude, practice of staff nurses about pharmacovigilance in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 1758
Author(s):  
Prema M. ◽  
Nalini G. K. ◽  
Sahana G. N. ◽  
Deepak P. ◽  
Jayashree V. Nagaral ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Reporting Rate ◽  
Staff Nurses ◽  
Care Hospital ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Correct Definition ◽  
Global Problems ◽  
Important Purpose ◽  
Related Harm

Background: Adverse drug reactions (ADR) - one of the global problems of major concern leading to morbidity and mortality. Spontaneous reporting of ADR is the cornerstone of Pharmacovigilance (PV) programme and it is important to reduce the risk of drug related harm to the patient. The active participation of healthcare professionals (Doctors, Nurses, Pharmacist) play a major role in the success of Pharmacovigilance. The objective of the study was to assess the knowledge, attitude, practice of Staff Nurses about Pharmacovigilance in a tertiary care hospital.Methods: A Cross sectional, Observational questionnaire based study was carried out using a pre designed KAP questionnaire. Study included 100 staff nurses who were working in Hassan institute of medical sciences (HIMS). The results were analyzed using descriptive statisticsResults: In our study 65% participants knows the correct definition and 48.8% knows the important purpose of Pharmacovigilance and 77.5% aware of existence of ADR reporting system in India. There was huge gap between ADR experienced (53.8%) and ADR reported (21.3%). The determinants of under reporting from our study include Lack of time / overburdened (33.7%) and lack of knowledge about ADR (31.25%).Conclusions: This study showed that majority of participants understand the need for reporting of ADR. In spite of that the reporting rate of ADRs by them is very low. Hence, there is a need to create awareness about the importance of reporting ADR by conducting many Pharmacovigilance programme.

scholarly journals Predictors of Disseminated Intravascular Coagulation in Patients with Septic Shock

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Diana J. Kelm ◽  
Juan Carlos Valerio-Rojas ◽  
Javier Cabello-Garza ◽  
Ognjen Gajic ◽  
Rodrigo Cartin-Ceba
Keyword(s):  
Septic Shock ◽  
Antiplatelet Therapy ◽  
Disseminated Intravascular Coagulation ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Model ◽  
Care Hospital ◽  
Clinical Predictors ◽  
Intravascular Coagulation ◽  
Early Goal Directed Therapy ◽  
Increased Risk

Purpose. The goal of this study was to identify potential clinical predictors for the development of disseminated intravascular coagulation (DIC) in patients with septic shock. Material and Methods. We performed a retrospective analysis of a cohort of adult (>18 years of age) patients with septic shock admitted to a medical ICU in a tertiary care hospital from July 2005 until September 2007. A multivariate logistic regression model was used to determine the association of risk factors with overt DIC. Results. In this study, a total of 390 patients with septic shock were analyzed, of whom 66 (17%) developed overt DIC. Hospital mortality was significantly greater in patients who developed overt DIC (68% versus 38%, P<0.001). A delay in the timing of antibiotics was associated with an increased risk of the development of overt DIC (P<0.001). Patients on antiplatelet therapy prior to hospital admission and who that received adequate early goal-directed therapy (EGDT) were associated with a decreased risk of overt DIC (P<0.001). Conclusions. In our cohort of patients with septic shock, there was a risk reduction for overt DIC in patients on antiplatelet therapy and adequate EGDT, while there was an increased risk of DIC with antibiotic delay.

Sign in / Sign up

Export Citation Format

Share Document