scholarly journals Maternal near miss: an Indian tertiary care centre audit

Author(s):  
Padmaja Y. Samant ◽  
Juhi Dhanawat

Background: In practical terms, women are considered near-miss cases when they survive conditions which threaten their life i.e. organ dysfunction. Despite advances in medical science and increased awareness of measures for safe childbirth, unacceptably high maternal morbidity and mortality continues to plague developing countries like India. Our’s being a tertiary care centre, draws a lot number of high-risk patients and referrals. By auditing these near miss cases, we aim to identify the causes, factors leading to near miss, to identify management gaps to prevent near misses and maternal death.Methods: Retro-prospective cross-sectional study done over one and a half year. Patients were included based on the inclusion criteria. A questionnaire was used to evaluate the prospective cases and the indoor case sheets were used for retrospective cases. After data entry in excel sheet, data analysis was done using SPSS 21. Results were tabulated.Results: High number of Near Miss cases with preeclampsia being the commonest. Lack of proper facilities at the periphery health centers was the most common cause for referrals. Level 1 and level 2 delays were found in most cases.Conclusions: Timely referral, with adequate treatment at the peripheral hospitals will majorly reduce Near miss. Hence, proper development and functioning of peripheral hospitals are needed.

2021 ◽  
Vol 59 (235) ◽  
Author(s):  
Anupama Thapa Basnet ◽  
Suraj Singh ◽  
Bijay Thapa ◽  
Anuj Kayastha

Introduction: Acute appendicitis is the most common reason for abdominal surgery in children. Though appendectomy considered the gold standard there are a lot of complications related to it. Conservative management of acute appendicitis is not new to medical science. In pandemic like COVID-19 when all the health systems were about to shut-down because of lack of manpower and resources, we started a trial of non-operative management. The main aim of this study is to find out the management of acute appendicitis during COVID-19. Methods: This was a descriptive cross-sectional study conducted in a tertiary care centre. Data collection was done from the record section which included the patients diagnosed with acute appendicitis from February 2020 to July 2020 after obtaining ethical clearance from Institutional Review Committee. Cases of appendicular lump, appendicular abscess, appendicular perforations have been excluded. Data was collected and entry was done in Statistical Package for the Social Science software version 20, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The conservative management of acute appendicitis was done in 44 cases (55.7%) while 35 cases (44.3%) had to undergo appendectomy. Conclusions: COVID-19 can complicate the perioperative course as a result of direct lung injury and multiple organ dysfunctions and can also bring serious threats to the safety of medical staffs involved in managing the acute appendicitis case operatively, so conservative management can be considered as an alternative way of management of acute appendicitis in the pandemic outbreak.


Author(s):  
Avanitaben D. Solanki ◽  
Neha S. Nagrani ◽  
Dhara V. Patel ◽  
Neela M. Patel ◽  
Jigna P. Barot ◽  
...  

<p class="abstract">Erosive pustular dermatosis of the scalp (EPDS) has been reported as a rare chronic and progressive non-infectious inflammatory condition of the actinically damaged scalp characterized by crusts, erosions and pustules. It tends to occur on the scalp of older people who have usually been treated for diffuse actinic damage and actinic keratoses. The list of possible differential diagnosis is long and includes tinea capitis, folliculitis decalvans, neutrophilic dermatosis, autoimmune vesiculobullous disorders, malignancy etc. Notoriously difficult to treat, these cases tend to be chronic and progressive. These patients often present after repeated treatment to various scalp dermatosis that doesn’t result in clearing instead persistence and perpetuation of the process. A cross sectional prospective study was conducted in department of dermatology in a tertiary care centre in which six cases of EPDS attending outpatient department from 2017 to 2019 were included. EPDS is more common but under recognized condition, hence less cases are reported till date. Increased awareness of and proper diagnosis of this condition changes the approach towards these patients, protects the scalp from involuntary insults and other precipitating factors that hinders with a better outcome.</p>


2021 ◽  
pp. 10-11
Author(s):  
Akhilesh Behra

BACKGROUND- Psoriasis is chronic common papulosquamous disorder. Its aetiology included various environmental and genetic factors. In genetics, HLA-Cw6 is most commonly associated with psoriasis. Childhood psoriasis is also common in worldwide population. However, very few studies done on epidemiological data and HLA-Cw6 analysis in childhood psoriasis patients. AIMS AND OBJECTIVE- Clinicoepidemiological study of childhood psoriasis patients and its association with HLA-Cw6 in a tertiary care centre of Eastern India MATERIALAND METHOD- We conducted a cross-sectional study in a tertiary care centre and recruited 20 patients of psoriasis with age group below 18 years after taking proper consent. Clinical history and blood was taken from them and HLA-Cw6 analysis was done by PCR method. Data compilation was done by Microsoft excel using SPSS software. RESULTS- A total of the 20 childhood psoriasis patients, 9 were males and 11 were females. Generalized plaque type psoriasis (N=19) is commonest followed by guttate psoriasis (N=1). None of the patients had arthalgia. Family history was present in only 3 patients. Higher numbers of childhood psoriasis patients (N=14) were positive for HLA-Cw6. Also Higher numbers of females (N=10) were positive for HLA-Cw6. ve patients had nail changes. CONCLUSION- We found HLA-Cw6 is strongly associated with childhood psoriasis and also HLA-Cw6 frequency is higher in female than male childhood psoriasis patients.


2017 ◽  
Vol 16 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Mohammad Arif Shahar ◽  
Ahmad Marzuki Bin Omar ◽  
Azarisman SM Shah ◽  
Mohammad Hadzri Hasmoni ◽  
...  

Objective: Patients beliefs determine their response to an illness and its management especially if it is chronic. Studies assessing patient’s knowledge of their epilepsy are scarce. We report the first objective study evaluating knowledge, attitude and practices of epilepsy patients referred to a tertiary care centre in East Coast of Malaysia.Materials and Methods: A cross sectional study using pre-tested, semi-structured questionnaire among consenting epilepsy patients.Results: The demographic details and responses to a questionnaire assessing their insight towards epilepsy were recorded. Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean = 31.63 ± 13.41). Majority (53.8%) of them aged equal or less than 30 years. The median number of years they had epilepsy was 8.0 (4.0, 18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (0.3, 4.5) years. The average number of years they were receiving treatment from a hospital was 5.50 ± 5.84. Most (90.9%) did not know the cause of epilepsy; however 93.9 % were aware that it can be treated with modern drugs. While only 22.7 % believed that faith healers can treat epilepsy, 74.2% had tried other forms of treatment. Negative attitude was reflected in the belief that epilepsy is due to supernatural powers (1.5%) and that epilepsy is contagious (17.4 %). Positive attitude included that PWE can take a job (66.7%), allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (54.5%), marry (65.9%) and having children (58.3%).Conclusions: Patients with epilepsy are not knowledgeable about their disorder. This is true regardless of age, educational background, or number of years with epilepsy. The results suggest that there is a critical need to enhance epilepsy education and improve attitudes towards epilepsy beyond seizure control.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.545-553


2019 ◽  
Vol 6 (17) ◽  
pp. 1300-1305
Author(s):  
Mansi Singh ◽  
Ajay Kumar ◽  
Sanjay Mehrotra ◽  
Virendra Atam ◽  
Ravi Mishra ◽  
...  

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