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

Author(s):  
Chirag Banker ◽  
Latika Mehta

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.

2021 ◽  
Vol 29 (1) ◽  
pp. 60-65
Author(s):  
Devang Gupta ◽  
Chaitry Shah ◽  
Vaishali Jain ◽  
Nikita Ganvit

Introduction Cut throat injuries are one of the challenging emergencies encountered in clinical practice. This study evaluates the causes and management of cut throat injuries.   Materials and Methods This was a retrospective study of total 100 cases of cut throat injury presented to the department of ENT in a tertiary care hospital in Ahmedabad between June 2017 and June 2019. Majority of patients were managed by suturing.   Results In our study 69% were males,31% were females. The peak age of incidence is 4th decade (55%). 70% of them have injury in Zone II. Seventy eight percent of the patients presented with active bleed without major vessel injury. The most common cause of cut throat injury had been found to be accidental (75%), 54% had injury up to muscular layer. Five patients were managed by laryngotracheal stent placement. Conclusion The middle aged males were mostly affected. The majority had zone 2 injury.  The most common cause was Accidental (seasonal manja/ kite thread cut). Primary repair is the best way to avoid complications.


Author(s):  
Hemalatha S. V. ◽  
Manickadevi M. S.

Background: The aim of the study was to analyse the causes of maternal mortality at a tertiary care centre and find measures to reduce it.Methods: A retrospective study of maternal deaths from January 2018 to December 2020 that occurred at Government Vellore Medical College and Hospital, a tertiary care hospital in Tamil Nadu. Data collected from case records and death reviews.Results: There was total of 71 deaths at the tertiary care hospital during the period January 2018 to December 2020 out of 31407 live births giving Maternal mortality rate of 226/1,00,000 live births. The MMR is high as it is a tertiary hospital catering referral from six districts. Most of the cases were due to late referrals. The majority of the deaths occurred in primigravida (50.7%), in the age group of 21 to 25 years (35.2%) and around term gestational age (49.3%). The most common cause of death in our study was hypertensive disorders of pregnancy (29.5%) followed by PPH (14.08%).Conclusions: From our study we concluded that the most common causes of maternal death were due to direct obstetric causes like severe pre-eclampsia, eclampsia and post-partum haemorrhage. Early identification of high-risk cases, early identification of GHT, anaemia and its correction, early referral of high-risk cases to tertiary centre can prevent most of the deaths. 


Author(s):  
Shahana I. Chandniwala

Background: The objective of this study was to know the local prevalence of congenital anomaly and study the maternal risk factors associated with it.Methods: Cross sectional descriptive study was carved out. All live babies were examined for presence of congenital anomalies and mother were looked for presence of socio-demographic factor.Results: In this study of 1 year 5767 live birth took place at tertiary care centre out of which 63 babies had congenital anomalies. Therefore, prevalence of congenital anomalies at tertiary care centre was 1.08%.Conclusions: The incidence of malformations were significantly higher in babies born to mothers over the age of 35 years and with parity 4 and above. 


2021 ◽  
Vol 10 (31) ◽  
pp. 2378-2383
Author(s):  
Ginni Datta ◽  
Sumit Narang ◽  
Manish Gupta ◽  
Soniya Arora

BACKGROUND The SARS-CoV-2 is known to be highly contagious from respiratory tract droplets and aerosol exposure. ENT surgeons deal with the upper airway and are exposed to aerosol generating procedures on a daily basis. Aerosol generating procedure such as tracheostomy is necessary in patients with head and neck cancers having airway obstruction. METHODS We share our experience of 38 cases where we had to perform tracheostomy during these Covid times under various circumstances in a tertiary care centre with a dedicated Covid Isolation centre for 5 districts with 210 beds reserved for Covid patients. RESULTS All 38 tracheostomies were performed successfully following the guidelines formulated by our team, with proper precautions not a single team member got infected with Covid-19. No test is 100 % sensitive, so all precautions must be taken while dealing with every patient and PPEs should be used in all tracheostomies. CONCLUSIONS No test is 100 % sensitive, so all precautions must be taken while dealing with every patient and PPEs should be used in all tracheostomies. Our policy of anticipating tracheostomy in patients with impending stridor helped us reduce the risk of having to perform emergency tracheostomies with Covid status unknown. KEY WORDS Aerosol, COVID-19, PPE - Kit, SARS-CoV-2, Stridor, Tracheostomy


Author(s):  
Mohanram Venkatesan ◽  
Arulraj Russelian ◽  
Palpandi Velimuthu

Background: For determining hyperbilirubinemia in a neonate, clinical evaluation, serum bilirubin estimation and trans cutaneous bilirubin estimation are the modalities available. Transcutaneous bilirubinometry (TcB) is routinely used to monitor jaundice in term and near-term infants. Literature shows a positive correlation observed between TcB and total serum bilirubin (TSB). The present study was conducted determine the correlation of TcB with TSB in neonates with hyperbilirubinemia admitted at a tertiary care hospital, ChennaiMethods: A cross sectional study was conducted at a tertiary care hospital, Chennai where 350 neonates who have clinical jaundice and require estimation of serum bilirubin who are admitted to the tertiary care centre, Chennai during December 2020-March 2021 were included in the study. The ROCHE INTEGRA-e 411+ autoanalyzer was used to estimate TSB (mg/dl) using a modified diazo method. The Jaundice Meter JM-103 to measure TcB, (Manufactured by Draeger medical systems, Germany). Pearson corelation coefficient was used to find the correlation between the two variables. P<0.05 was considered to be statistically significant.Results: Out of 350 neonates admitted to the tertiary care centre, term deliveries were 57.1% and pre term were 42.9%. 83.1% were in the age group of 3-7 days. The mean weight of the study population was 2.16±0.60 kg. In term babies, Pearson corelation between TSB and TcB shows a statistically significant positive correlation, r=0.90 with p≤0.0001. Among pre term babies, Pearson corelation between TSB and TcB shows a statistically significant positive correlation, r=0.96 with p≤0.0001.Conclusions: This study's findings support the use of a TcB metre as a screening tool for clinically significant hyperbilirubinemia.


2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.


Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.


Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.


Author(s):  
Yamini Marimuthu ◽  
Radhika Kunnavil ◽  
NS Anil ◽  
Sharath Burugina Nagaraja ◽  
N Satyanarayana ◽  
...  

COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19.  This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention.  Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.


Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya

Background: Over the last few decades, there has been an alarming increase in the rate of deliveries by caesarean section (CS) in most of the countries, though the drivers of this trend are not completely understood. In 1985, WHO had proposed that ideal rate for regional CS rates should not exceed 10-15%. The Robson’s classification system is simple, robust and flexible. The study was done as it was important to have a tool to monitor, compare the CS rates in a same setting and between different settings over a period of time and to optimise the CS rates.Methods: It was a retrospective study conducted in the department of obstetrics and gynaecology in a tertiary care centre. The hospital delivery records were reviewed for a period of 15 months from April 2020 to June 2021.Results: The total number of deliveries during the study period was 1016. The total number of CSs was 441 and the total number of vaginal deliveries was 575.The CS rate was 43.4%. The relative contribution from groups 1, 2 and 5 in our study accounted for 76.36% and group 5 accounted for 44.4% of the total CSs. These 3 groups should be the focus of attention to reduce the overall CS rates.Conclusions: It is advisable that all institutions can use the Robson’s report table to analyse the population catered by them and to make institutional specific policies. This will allow comparing the data amongst the different institutions and countries which can help in policy making.


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