scholarly journals A root cause analysis of increasing caesarean section rates in a tertiary care private hospital in North India

2019 ◽  
Vol 8 (11) ◽  
pp. 4531
Author(s):  
Bela Makhija ◽  
Deepika Verma ◽  
Asif Mustafa
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Cultural Factors ◽  
North India ◽  
New Delhi ◽  
Care Hospital ◽  
Cross Sectional ◽  
Group 2

Background: Increase in the incidence of caesarean section is a matter of concern worldwide. Robson’s criteria which is universally accepted now as a way for calculating caesarean rates takes into account only the obstetrical consideration, however, it is noteworthy that many socioeconomic and cultural factors also have a role to play. This study takes into account both Robson’s criteria and common socio-cultural factors which lead to increased caesarean rates with an attempt to suggest ways to curtail this trend.Methods: The study was a hospital based cross-sectional study at a private tertiary care hospital in New Delhi. 1200 consecutive live births after 34 weeks of gestation were analysed over a period of one year.Results: LSCS was the most common mode of delivery 733 (61.1%). 329 (27.4%) had induced labour of which 260 (76.2%) had LSCS. 333 women had elective LSCS. Rates of CDMR were 185 (25.2%) which is very significant. As per Robson’s criteria maximum number of women (318) were in group 2, of which 226 (71.1%) underwent caesarean section.Conclusions: High caesarean rates can be attributed to a multitude of factors. Robson’s criteria are an effective way for analysis of obstetric indications. Other added factors include comorbidities, CDMR, fear of litigations, etc which were analysed.

scholarly journals Robson’s Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1098-1101
Author(s):  
Pratigyan Gautam ◽  
Chanda Karki ◽  
Asmita Adhikari
Keyword(s):  
Caesarean Section ◽  
Confidence Interval ◽  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 2

Introduction: Globally, there is a dramatic rise in cesarean section rate which has increased the maternal morbidity and adverse effects in a subsequent pregnancy. Robson’s classification will aid in the optimization of the cesarean section use, assessment of the strategies aimed to decrease the cesarean section rate and thus improve the clinical practices and quality of care in various health care facilities. The main aim of this study is to find out the prevalence of caesarean section for Robson’s group 2 among total caesarean sections done in a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out at a tertiary care centre in Nepal from August 2020 to January 2021. Ethical approval was taken from the institutional review committee (reference number: 1607202003) and data were entered using Robson’s criteria. The convenient sampling technique was used. Data was analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: According to Robson’s group 10 classification, among 380 caesarean sections, 110 (28.94%) (24.38-33.50 at 95% Confidence Interval) cases were in Robson’s group number 2. Conclusions: This study showed that the prevalence of caesarean section which lies in Robson’s group 2 in our study is higher than the standard of World Health Organization. It showed that Robson’s group 2 was one of the significant contributors to the greater caesarean section rate. Improved case selection, standardization, and protocol for induction of labour as well as regular audit could also reduce caesarean section rates.

scholarly journals SOCIO-CULTURAL FACTORS ASSOCIATED WITH NATURAL OPIOIDS USE IN NORTHWESTERN RAJASTHAN: A CROSS-SECTIONAL STUDY FROM TERTIARY CARE HOSPITAL.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Vijay Kumar Saini ◽  
Dheeraj Goya ◽  
Pratibha Gehlawat
Keyword(s):  
Tertiary Care ◽  
Work Capacity ◽  
Cross Sectional Study ◽  
Cultural Factors ◽  
North India ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Natural Form ◽  
Factors Associated

Background: Opioid in natural form (afeem/amal and poppy husk) has been taken from ancient time in north India including Rajasthan. There are approximately 2.3 crore opioid users in India, according to National Survey. Various psychosocial and cultural factors are associated with its use. Socio-cultural factors for the use of natural opioids are inadequately studied. With this rationale, we planned a study to identify these socio-cultural factors. Method and Material: This was a descriptive, cross-sectional study. 136 subjects were recruited. Along with socio-demographic profile, a semi-structured proforma of various socio-cultural factors was used. Results: The majorities of subjects were male (97%), married (88.23%), farmer (62.50%), illiterate (44.11%) and hailed from rural areas (92.65). Most common factors associated with starting opioids were to increase work capacity in agricultural work (n= 46; 33.82%) followed by staying away from home for work (n= 36; 26.47%) and usage by another family members (n=34; 25%). Participants were continuously using natural opioids as it increases work capacity and concentration (n=61; 44.85%) and the reasons for quitting were unavailability and financial problems (n=60; 44.12%).  Conclusion: Various socio-cultural factors play important role in initiation and maintenance of natural opioids use.  Key words:  Natural opioids, Opioid dependence, Socio-cultural factors, Northwestern Rajasthan, Agriculture work

scholarly journals Stigma for Mental Disorders among Nursing Staff in a Tertiary Care Hospital

2020 ◽  
Vol 11 (02) ◽  
pp. 237-244
Author(s):  
Sandeep Grover ◽  
Neha Sharma ◽  
Aseem Mehra
Keyword(s):  
Mental Disorders ◽  
Nursing Staff ◽  
Mentally Ill ◽  
Positive Attitude ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
North India ◽  
Care Hospital ◽  
Cross Sectional

Abstract Objective This study aimed to evaluate the prevalence of stigma for mental disorders among nursing staff in a tertiary care hospital, and the secondary objective of the study was to assess the correlation of stigma with the socio-demographic profile and previous experience with mentally ill patients. Methods This cross-sectional study was performed among the 210 nurses working in a tertiary care multispecialty teaching public sector hospital in north India. They were evaluated on community attitudes toward the mentally ill (CAMI) scale. Results About two-thirds of the participants (67.1%) were females and had done graduation (64.2%) in nursing. Nearly 50% of the study participants had an experience of working with mentally ill patients. Female had a more significant positive attitude on the domain of social restrictiveness. Authoritarianism had a significant positive correlation with benevolence and social restrictiveness domains. The benevolence domain had a significant correlation with all other domains. Social restrictiveness domain also had a significant correlation with other domains. Conclusion Nurses have a positive attitude toward mentally ill patients.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Evaluation of smear microscopy and geneXpert for the rapid diagnosis of pulmonary and extrapulmonary tuberculosis in a tertiary care hospital in North India: a descriptive prospective study

2018 ◽  
Vol 6 (5) ◽  
pp. 1756
Author(s):  
Danish Zahoor ◽  
Anjum Farhana ◽  
Farhath Kanth ◽  
Munazah Bha
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Rapid Diagnosis ◽  
North India ◽  
Smear Microscopy ◽  
High Morbidity ◽  
Care Hospital ◽  
Cross Sectional ◽  
Xpert Assay

Background: Tuberculosis is a global health problem associated with high morbidity and mortality. Rapid diagnosis of tuberculosis is essential for early disease management. Conventional methods like microscopy and culture are associated with low sensitivity and longer time to positivity respectively. The GeneXpert is an integrated device for the rapid detection of Mycobacterium tuberculosis and its sensitivity to rifampicin. We evaluated the performance of gene expert MTB/ RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculosis.Methods: A prospective cross sectional study was carried out in the Department of Microbiology. Samples were subjected to smear microscopy by ZN staining, culture on solid (LJ) and liquid media (BacT Alert) and GeneXpert assay.Results: 122 pulmonary samples and 153 extrapulmonary samples collected from 275 patients were included in the study. Out of these, 48 samples were positive by both culture and Xpert assay and 2 samples were culture positive only. Out of 225 culture negative samples, 3 were positive by GeneXpert. The sensitivity for GeneXpert was much higher compared to smear micrscopy (96 Vs 46% respectively). The Xpert assay also detected 3 rifampcin resistant cases.Conclusions: The test appeared to be as sensitive as culture for the detection of tuberculosis in smear positive, smear negative and extrapulmonary tuberculosis. We recommend the use of GeneXpert assay for the early detection of tuberculosis. We conclude that the test is simple and routine staff can perform the test with minimal training.

scholarly journals Hydroxychloroquine pre-exposure prophylaxis provides no protection against COVID-19 among health care workers: a cross-sectional study in a tertiary care hospital in North India

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Shivani Juneja ◽  
Proteesh Rana ◽  
Parvinder Chawala ◽  
Rekha Katoch ◽  
Kulvir Singh ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Virus Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
North India ◽  
Weekly Dose ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Exposure Prophylaxis

Abstract Objectives The use of Hydroxychloroquine (HCQ) prophylaxis has been recommended by the National task force constituted by the Indian Council of Medical Research (ICMR) for the prevention of corona virus disease 2019 (COVID-19) among healthcare workers (HCWs). However, this recommendation was based essentially on the preclinical data and limited clinical experience. The aim of this study was to evaluate the efficacy and safety of HCQ as a pre-exposure prophylaxis for COVID-19 infection among Indian HCWs. Methods A cross-sectional study was conducted among HCWs of a tertiary care hospital in north India. The HCQ prophylaxis was initiated among 996 HCWs and they were followed up to 8 weeks for conversion to COVID-19 positive status and any adverse drug reaction (ADR). Results About 10.3% of the study participants were tested positive for COVID-19 which was comparable to the positivity rate among HCWs not taking HCQ prophylaxis (9.7%). Conclusions HCQ was well tolerated at a weekly dose of 400 mg for 8 weeks but provided no additional benefit in prevention of COVID-19 among HCWs.

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