scholarly journals Trends of caesarean section: an analytical overview of indications

2019 ◽  
Vol 9 (1) ◽  
pp. 288
Author(s):  
Shruti A. Gavhane ◽  
Shilpa N. Chaudhari
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Graphical Representation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Chi Square Test ◽  
Evidenced Based

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.

scholarly journals The rate and indications of caesarean section in a tertiary care hospital at Jaipur, India

2017 ◽  
Vol 6 (5) ◽  
pp. 1786
Author(s):  
Meeta Gupta ◽  
Vineeta Garg
Keyword(s):  
Caesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Morbidity And Mortality ◽  
High Rate ◽  
North India ◽  
Care Hospital ◽  
Failed Induction ◽  
Evidenced Based

Background: Caesarean section is one of the most widely performed surgical procedures in obstetrics worldwide. It was mainly evolved as a lifesaving procedure for mother and foetus during the difficult delivery. To analyze the rate and indications for C-Section and associated maternal morbidity and mortality were the main objectives of present study.Methods: This retrospective study was conducted over a period of one year from 1st Jan 2016 to 31st Dec 2016 at the Department of OBG, RUHS College of Medical Sciences, Jaipur (Rajasthan), North India. Data of patients who delivered by C-Section in our hospital during the defined study period was recorded and a statistical analysis of various parameters namely, the caesarean section rates, its indications, the patient’s morbidity and mortality was done.Results: The total numbers of women delivered over the study period were 2959, out of which C-Sections were 931. The overall CS rate was 31.46%. Previous LSCS was the leading indication to the CS rate (36.52%) followed by arrest of labour (13.65%), CPD (12.03%), foetal distress (11.82%), breech presentation (7.52%), oligohydroamnios/IUGR (5.16%) and failed induction of labour (3.54%). 11.60% patients had various complications mainly infection (5.58%) and haemorrhage (3.98%). There was no mortality during this period.Conclusions: Being a tertiary care hospital, a high rate of Caesarean deliveries was observed. Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit CSR.

scholarly journals Incidence and Pattern of Adverse Events in Pentavalent Vaccine Recipients in Pune, India

2017 ◽  
Vol 16 (1) ◽  
pp. 8-13
Author(s):  
Barun Bhai Patel ◽  
Kapil Harish Pandya ◽  
Bikal Shrestha ◽  
Raj Kumar ◽  
Atul Kotwal
Keyword(s):  
Institutional Delivery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Safety Monitoring ◽  
Exposed Group ◽  
Care Hospital ◽  
Chi Square ◽  
Pentavalent Vaccine ◽  
Chi Square Test ◽  
Hep B

Introduction: Safety monitoring of vaccines used in routine programmes on immunization is important in all settings. There is a lot of debate in the country about the relevance of the pentavalent vaccine in general and the Hib component in particular, in view of reports of deaths in children following immunization. This study was conducted to evaluate the incidence and profile of AEFI in children receiving pentavalent vaccine. Methods: A cohort study was conducted between May to Oct 2012, in a tertiary care hospital, Pune. Exposed groups received pentavalent vaccine, while the control received DPT or DPT + Hep B. Both the groups were followed up telephonically after 24 hr, 48 hr, 72 hr and 7 days following vaccination. 175 children in both groups were studied. Convenient sampling was done recruiting consecutive vaccinees till the sample size was achieved. Frequency, percentage, mean difference (T test) and chi square test was used to find associationResults: 100 % children were institutional delivery. In controls, 80 % received DPT and Hep B, rest received only DPT. Fever was present in 76.2 % among exposed and 26.7% among non-exposed. Presence of fever after 1 day following immunization was significantly associated with exposed group (P=0.003). In 19 % exposed group fever continued for 2nd day. Other side effects included swelling (4.8 %) and reduced appetite (4.8 %) among exposed.Conclusion: Pentavalent vaccine does not increase the probability of deaths among the vaccines vis-a-vis nor receivers. The profile of AEFI among both the groups, except fever, is similar as far as frequency and severity is concerned. 

scholarly journals Indications and rate of caesarean delivery at tertiary care hospital: a retrospective study

2017 ◽  
Vol 6 (10) ◽  
pp. 4367
Author(s):  
Reena Sharma ◽  
Poojan Dogra
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Number Of Patients ◽  
Increasing Trend

Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. Objective of the study was to assess the prevalence and different indications of caesarean section in this institute.Methods: The aim of the study is to analyse the rates and indications of lower segment caesarean section (LSCS) in our institution. We conducted a retrospective study over a period of six months; 1st September 2016 to 1st March 2017 at SLBSGMC Mandi at Nerchowk. Total number of patients who delivered in our hospital during the defined study period was recorded and a statistical analysis of various parameters was done.Results: The total number of women delivered over the study period was 2075, out of which caesarean sections (CS) were 473. The overall CS rate calculated was 22.8%. Previous LSCS was the leading indication to the CS rate.Conclusions: Routine obstetric audits should be done to analyse the various indications of emergency and elective caesarean sections so that protocols and guidelines can be implemented to curtail the increasing trend of caesarean delivery.

scholarly journals 3-Month Symptom-Based Ambidirectional Follow-up Study Among Recovered COVID-19 Patients from a Tertiary Care Hospital Using Telehealth in Chennai, India

2021 ◽  
Vol 58 ◽  
pp. 004695802110601
Author(s):  
G Shiny Chrism Queen Nesan ◽  
D Keerthana ◽  
Raja Yamini ◽  
Timsi Jain ◽  
Dinesh Kumar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severity Of Illness ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Chi Square ◽  
Mood Changes ◽  
Chi Square Test

Objectives Post-COVID-19 symptoms and its features in many recovered patients are almost similar to post-severe acute respiratory syndrome. The study aims to assess the outcome and manifestations during post-COVID follow-up period in recovered patients. Methods Ambidirectional longitudinal study was conducted among recovered COVID-19 patients from a tertiary care hospital near Chennai through telephonic interview after discharge. Total admitted patients from June to November 2020 were 3496 and among those 183 died and 12 transferred to other hospitals. Totally 1354 consented for study and the rest were wrong numbers or not willing to participate. Chi-square test and multinominal logistic regression analysis were done. Results Majority of, that is, 27.6% and 18.7% were in 21–30 years and >60 years, respectively. Majority were admitted with fever (38.3%), cough (15.3), and body pain (10%). Post-COVID symptoms reported were fatigue (39.7%), stress and anxiety (27.6%), and mood changes (5.8%). Some patients were newly diagnosed with diabetes mellitus (10), hypertension (5), and TB (1) after discharge. Having diabetes mellitus is an independent risk to have neurological and cardio-respiratory symptoms and patients who were discharged with minimal support were to have an independent risk factor of renal symptoms on follow-up than other subjects. Conclusion The follow-up symptoms were associated with the patients’ comorbidities, age, severity of illness, and environmental factors.

scholarly journals Epidemiological Profile and Clinical Outcome of COVID-19 Patients in a Tertiary Care Hospital, Pune, India

2021 ◽  
Author(s):  
Prachi D Sondankar ◽  
Shubhangi U Agawane ◽  
Abhay B Mane ◽  
Parvinder S Chawla
Keyword(s):  
Clinical Outcome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
High Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
The World ◽  
Epidemiological Profile

Introduction: The COVID-19 caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has spread throughout the world from its place of origin in Wuhan city of China. From origin in December 2019 till May 2021, this disease affected 222 countries in the world with 152,534,452 confirmed cases. As on May 2021, India is the second worst affected country in the world. Aim: To know the epidemiological profile and clinical outcome of COVID-19 positive patients to help in understanding the disease dynamics. Materials and Methods: It was a cross-sectional, record based study at a tertiary care hospital. All the COVID-19 laboratory confirmed positive patients admitted from 15th June, 2020 to 15th September, 2020 were included in the study. Sample size was 1146. All the required data regarding patients were collected and analysed subsequently with the help of percentages, Z-test for proportion, Chi-square test and Odds ratio. Results: The mean age of the patients was 47.06 ±17.4 years ranging from 1 to 92 years. Males were significantly higher in numbers than females. 30.19% patients had some or other co-morbidities. 89.8% patients were discharged and 9.2% patients died. More number of deaths occurred in higher age group and highest death rate was seen in the patients who had multiple co-morbidities. Conclusion: The study concludes that most of the COVID-19 patients were middle aged and males were significantly more affected than females. Most of the patients were asymptomatic at the time of admission. It can be concluded that maximum patients had favourable clinical outcome as around 90% patients being discharged and case fatality rate was 9.2%. High rate of mortality was significantly associated with higher age and presence of co-morbidities.

scholarly journals The rate and indication of caesarean section in a tertiary care teaching hospital eastern India

2018 ◽  
Vol 5 (5) ◽  
pp. 1733
Author(s):  
Ratan Kumar Das ◽  
K. Trimal Subudhi ◽  
Ranjan Kumar Mohanty
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Morbidity And Mortality ◽  
High Rate ◽  
Care Hospital ◽  
Eastern India ◽  
Medical College ◽  
Failed Induction ◽  
Evidenced Based

Background: Caesarean section is one of the most widely performed surgical procedures in obstetrics worldwide. It was mainly evolved as a lifesaving procedure for mother and foetus during the difficult delivery. To analyze the rate and indications for C-Section and associated maternal morbidity and mortality were the main objectives of present study.Methods: This retrospective study was conducted over a period of one year from 1st May 2017 to 30th April 2018 at the Department of Pediatrics and OBG, IMS & SUM Medical college and Hospital, Bhubaneswar (Odisha), eastern India. Data of Patients who delivered by C-Section in our hospital during the defined study period was recorded and a statistical analysis of various parameters namely, the caesarean section rates, its indications, the patient’s morbidity and mortality was done.Results: The total numbers of women delivered over the study period were 1619, out of which C-Sections were 574.The overall CS rate was 35.45%. Previous LSCS was the leading indication to the CS rate (29.96%) followed by arrest of labour (13.94%), CPD (11.84%), foetal distress (10.97%), breech presentation (5.74%), oligohydroaminous/IUGR (5.21%), failed induction of labour (5.21%), pregnancy induced hypertension(PIH) (4.87%) and multifetal gestation (3.84%), prematurity (3.31%). 12.01% patients had various complications mainly infection (6.27%) and hemorrhage (3.48%). There was no mortality during this period.Conclusions: Being a tertiary care hospital, a high rate of Caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit CSR.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

Study on Maternal and Neonatal Outcome of women undergoing Caesarean Section using Nice Classification in a Tertiary Care Hospital in Rural Area of Central India - An Observational Prospective Study

2021 ◽  
Vol 17 ◽  
Author(s):  
Shuchi M. Jain ◽  
Ketki. Thool ◽  
Manish A. Jain ◽  
Poonam V. Shivkumar
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Neonatal Outcome ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Central India ◽  
Neonatal Morbidity ◽  
Bladder Injury ◽  
Care Hospital ◽  
Chi Square

Background : Caesarean section is often perceived to be safer than vaginal delivery for mothers and neonates, and thus has become increasingly common around the globe. However, it may actually be detrimental to maternal and neonatal health while consuming valuable resources. Objective : The objective of this study was to categorize the caesarean sections performed in our rural institute into various categories using NICE classification and to study the maternal and neonatal outcome in them. Method : This was a prospective study of all women who underwent caesarean section over a period of 18 months. Data was retrieved from the files of women for morbiditiy and mortality in mothers and babies. Data was entered in MS excel sheet and analyzed with percentages and chi square test using SPSS ver.17. Results: Caesarean section rate (CSR) was 36.88%. All CS were classified into four categories based on urgency as per NICE guidelines. There were 22.62% women in Category I, 38.61% in category II, 28.37% in category III and 10.40% in Category IV. Adhesions, extension of angle, lacerations in lower segment, scar dehiscence, atonic PPH and bladder injury were noted in (12.83%), 11.81%, 6.83%, 4.08% , 1.53% and 0.08% CS respectively. Caesarean hysterectomy was done in 0.24% cases. Postoperative morbidity was febrile morbidity (11.93%), postdural puncture headache (13.85%), paralytic ileus (11.49%), wound infection (8.83%), ARDS (0.70%), sepsis (0.78%), pulmonary edema (0.47%) and pulmonary embolism (0.03%). Maternal mortality was 0.03%. Neonates born were 2577 (29 were twin deliveries). 82.46% neonates were healthy, 16.80% had morbidities and 0.74% were still born. Apgar score of less than 7 was in 10%. 16.80% neonates were admitted in NICU during their hospital stay. Neonatal mortality was 1.47%. Conclusion : Intraoperative and post-operative complication were more in caesarean sections of category I and II as compared to category III and category IV. Neonatal morbidity, mortality and admissions to NICU were more in caesarean sections of category I and II as compared to category III and category IV. Thus though caesarean section is an emergency lifesaving procedure for mother and baby it may prove detrimental to their health.

Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

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