scholarly journals Pregnancy outcome in patients with fibroid: a retrospective study

2020 ◽  
Vol 9 (11) ◽  
pp. 4428
Author(s):  
Bintu H. Dadhania ◽  
Shital T. Mehta ◽  
Pushpa A. Yadava ◽  
Bina M. Raval ◽  
Bhavi S. Shah ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Preterm Labour ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Delivery Mode ◽  
Age Group ◽  
Antenatal Period

Background: Fibroids are benign smooth muscle cell tumour of the uterus. In some patients of pregnancy associated with fibroid, it does not affect the outcome of pregnancy. On the other hand, various complications have been reported. The aim of our study was to evaluate the outcome in antenatal women with fibroids.Methods: This retrospective study was conducted at tertiary care center, obstetrics & gynecology department over a period of eighteen months between June 2018 to November 2019. Total 26 pregnant patients with >3 cm fibroid was included in the study. They were followed during antenatal period. Maternal age, parity, size of fibroid, complications during pregnancy, labour, and delivery, mode of delivery and indications of cesarean section were noted.Results: Out of 26 patients, 15 (57.6%) were between 26-30 years of age group and 16 (61.53%) were multigravidas. Normal vaginal delivery occurred in 8 (33.33%), while 16 (66.66%) delivered by caesarean section. There were 9 (34.61%) patients who had no complication whereas 17 (65.38%) had some complication. Pain was present in 8 (30.76%). PROM and preterm labour were present in 3 (18.75%) and 5 (19.23%) respectively. PPH was present in 2 (7.69%).Conclusions: Pregnant patients who have fibroids are to be carefully screened in the antenatal period, so as to have a regular follow up. The widespread use of ultrasonography has facilitated diagnosis and management of fibroids in pregnancy. The site and size of fibroid is very important to predict its effect on pregnancy.

scholarly journals Fetomaternal Outcome in Twin Pregnancies: A Retrospective Analysis from a Tertiary Care Centre

2020 ◽  
Author(s):  
Kamlesh Kumari ◽  
Minakshi Misra ◽  
Ambika Jhanwar ◽  
Asha Kumari
Keyword(s):  
Twin Pregnancy ◽  
Preterm Labour ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Maternal Risk ◽  
Antenatal Period ◽  
The Mean ◽  
Twin Pregnancies

Introduction: Twin pregnancies are among the major challenges faced by obstetricians globally. Increased maternal and foetal morbidity is observed with an increase in the incidence of twin pregnancies. Due to elevated rates of complications, a larger number of caesarean sections are performed in twin pregnancies in comparison to singleton gestation. Aim: The study aimed to find out the incidence of twin pregnancy with associated maternal risk factors and foetal outcome in the study population. Materials and Methods: This retrospective observational study was carried out at JNU Hospital and Medical College, Jaipur for a period of 4 years from December 2015 to December 2019. A total of 70 mothers, who presented with twin pregnancy, were included in this study. Data were collected from hospital records regarding maternal age, parity, whether spontaneous or assisted conception, gestational age, pregestational Body Mass Index (BMI) and family history. Details of maternal and foetal complications that occurred during the antenatal period and labour as well as the mode of delivery were collected and analysed. Statistical significance was considered if the p-value was ≤0.05. Qualitative data were represented as rate and proportions, while quantitative data were represented as mean and standard deviation. Results: A total of 70 mothers with twin births, resulting in 140 babies during the 4 years study period were included. A total of 4240 deliveries overall during the study period, gave a twin pregnancy incidence rate of 16.5 in 1000 deliveries. Preterm labour (25.4%), anaemia (26.8%) and hypertension (22.5%) were common problems. The most common indication for caesarean delivery was foetal malpresentation (37.8%) The mean weight of the first twin was 2.12±0.35 kg while the mean weight of the second twin was 1.97±0.30 kg. Among foetal complications, Intrauterine Growth Restriction (IUGR) was seen in 11.4% and birth weight discordance in 21.4% of children. A low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score was noted in 21.4% of babies, while 12.9% of babies died in the early neonatal period. Conclusion: Maternal complications during twin pregnancy were mainly preterm labour, diabetes, hypertension and anaemia. Caesarean section was the main mode of delivery in this study with significant association with hypertension and preterm labour. Foetal complications were in the majority related to IUGR. More vigilance during the antenatal period and labour is needed for proper selection of mode of delivery. Active foetal surveillance and intervention with appropriate neonatal care can improve fetomaternal outcome.

DOZ047.121: Usefulness of conservative treatment in recurrent tracheoesophageal fistula in children

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
S Isoldi ◽  
F Torroni ◽  
S Faraci ◽  
V Balassone ◽  
F Rea ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Tracheoesophageal Fistula ◽  
Surgical Repair ◽  
Care Center ◽  
Tertiary Care ◽  
Endoscopic Management ◽  
Endoscopic Evaluation ◽  
Recurrent Pneumonia ◽  
Endoscopic Techniques

Abstract Introduction Recurrent tracheoesophageal fistula (TEF) is a challenging complication in children with repaired esophageal atresia (EA). Thoracotomy, with surgical repair, is the traditional therapeutic approach, however it is often associated with a significant morbidity and technical difficulty. Endoscopic techniques, from the tracheal and/or esophageal side, have recently been proposed as a primary treatment, in order to prevent reoperation especially in previously operated fields. Aim of this retrospective study is to present our experience as Tertiary Care Center and Referral Center for EA, on the endoscopic management of recurrent TEF in children with repaired EA. Method This is a retrospective study conducted on children with repaired EA referred at Bambino Gesù Children's Hospital from January 2009 to January 2019. Demographic and clinical details, including type of EA, presence of fistula, concomitant malformations, endoscopic evaluation, number and kind of treatments, performed were collected. Results We identified 171 patients with EA, 15 type 1 (9%), 7 type 2 (4%), 140 type 3 (82%), 6 type 4 (3%), 3 type 5 (2%). Among patients with TEF, 11/156 (7%- M:F/6:5) presented with a TEF recurrence. Among the latter, 5 (45.4%) were patients with concomitant malformation (2 VACTER, 2 anorectal malformation, 1 Down syndrome, cardiac abnormalities, and hypothyroidism). All patients with TEF recurrence presented with symptoms, such as chronic cough, vomit, bronchitis, recurrent pneumonia, and failure to thrive. All patients underwent endoscopic evaluation both from digestive and tracheal side. Six (6/11–54.5%) patients underwent surgery, 5 patients (5/11–45.4%) were treated with endoscopic transtracheal fibrin glue injection after brushing that was successful in two patients (2/5–40%), one patient needed a retreatment. These patients maintained successful closure after treatment confirmed at endoscopic follow-up. Remaining three patients needed surgical approach during follow-up. Conclusion Endoscopic repair of recurrent TEF has proved safe and effective in the literature as an alternative to a second open thoracotomy/surgical repair. In our series, although in two cases, it represented a valid alternative to surgery. We suggest that it is worthy to try a conservative approach before surgery.

scholarly journals Disability and Deformity in Patients of Hansen’s Disease Attending a Tertiary Care Center in Nepal

2020 ◽  
Vol 19 (1) ◽  
pp. 26-30
Author(s):  
Sagar Mani Jha ◽  
Nabin Bhakta Shakya ◽  
Sunil Shakya ◽  
Manisha Maharjan
Keyword(s):  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Lepromatous Leprosy ◽  
Age Group ◽  
Cross Sectional ◽  
Social Wellbeing ◽  
Number Of Patients ◽  
Leprosy Patients

Introduction: Leprosy is responsible for disability and deformity among patients. Nerve damage is one of the main features of leprosy and it is the main cause of disability in the patients. Developing deformity leads to restriction in professional work and hence reduced income as well as it also acts adversely on social wellbeing. The aim of this study was to study the spectrum of Grade 2 disability among all leprosy patients attending outpatient and inpatient according to WHO grading and to find the association with Ridley Joplingclassification. Methods: It was an observational cross sectional hospital based study. All the inpatients and outpatients of leprosy getting treatment and were on follow up in the Department of Dermatology between December 2017 to November 2019 were included. Details of disability and deformity were recorded and were Classified as per WHO grading and Ridley Jopling classification. Cross tab was used in descriptive analysis to compare between different variables and data was analysed in percentage. Results: A total of 88 patients were included in the study. Maximum number of patients 41 (46.7%) belonged to 30 to 50 years of age group. Various degrees of loss of sensation was seen in all patients and total number of patients with Grade 1 disability were 68 (77.3%) and Grade 2 disability were 20 (22.7%). Maximum number of patients 11 (12.5%) with Grade 2 disability was seen in Lepromatous Leprosy. Conclusions: Disability and deformity can occur in any spectrum of disease and intervention as early as possible will help reduce the incidence.

scholarly journals An experience with COVID-19 positive pregnant patients at a tertiary care center

2021 ◽  
Vol 10 (4) ◽  
pp. 1463
Author(s):  
Anshu Baser ◽  
Akriti Gupta ◽  
Sunil Sharma ◽  
Sushil Kumar
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Protective Equipment ◽  
Delivery Mode ◽  
State Governments ◽  
Adherence To Guidelines ◽  
Major Complications

Background: The Covid-19 pandemic is a global phenomenon. The lockdown imposed by the central and state governments, has also led to restriction of movement of patients thus reducing their access to antenatal care. Our hospital was officially declared as a Covid-19 centre as per government directives. The hospital has been managing Covid-19 positive patients as per guidelines. We here present the data of management of COVID-19 positive pregnant patients.Methods: A retrospective study. All COVID positive patients admitted to the obstetric unit of the hospital from 23 March 2020 to November 2020 were analysed. A total of 96 COVID positive patients were analysed. The patients were analysed for antenatal complications, complications during delivery, mode of delivery and neonatal complications.Results: There was only one patient with major complications associated with COVID. Most of the patients were either asymptomatic or had mild symptoms. There was only one maternal mortality. 23 out of the 89 antenatal cases required emergency caesarean section. The caesarean section rate was higher in COVID positive patients though the caesarean sections were done for obstetric indications only. Three neonates tested positive for the virus. 2 of the neonate required NICU admission.Conclusions: COVID-19 is a completely unprecedented situation. The aim of this study was to demonstrate that the effect of COVID-19 on pregnant women is minimal. There were only 2 patients with major complications. The COVID positive pregnant patients can be managed effectively with proper personal protective equipment and adherence to guidelines.

scholarly journals Trends of laparoscopic gynecologic surgeries in a tertiary care center: A five-year retrospective study

2019 ◽  
Vol 1 (1) ◽  
pp. 26-30
Author(s):  
Asmita Ghimire ◽  
Padam Raj Pant ◽  
Nilam Subedi ◽  
Samriddha Raj Pant
Keyword(s):  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Ovarian Cyst ◽  
Diagnostic Laparoscopy ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Common Procedure ◽  
Current Trends

Background: The use of laparoscopic surgery in modern gynecology has led to faster recovery, lesser hospital stay, and fewer complications. In this study, we aim to analyze the current trends in laparoscopic surgery, its indications, type of procedure and associated complications. Method: This is a retrospective study done in Grande International Hospital. All patients who underwent laparoscopic surgery over a duration of 5 years from July 2013 to June 2018 were analyzed. Result: There were a total of 419 laparoscopic surgeries (74 diagnostic, 345 therapeutic) performed. The most common age group of patients for diagnostic laparoscopy was 25-34 years and for therapeutic was 45-54 years. Therapeutic surgery was mostly performed for ovarian cyst (144, 41.74%). There were a total of 152 (44.06%) laparoscopic hysterectomies performed. Complications which occurred during the surgery were insignificant (p<0.01). Conclusion: Laparoscopic surgery has become the most common procedure for gynecological procedures over the years.

scholarly journals Tibial Diaphysis Fracture in Paediatric Age Group: Outcome with Elastic Nailing Fixation in Tertiary Care Center in Lumbini Province of Nepal

2021 ◽  
Vol 4 (1) ◽  
pp. 8-10
Author(s):  
Sagar Panthi ◽  
◽  
Rishiswor Shrestha ◽  
Sabal Krishna Gaihre ◽  
Angelica Karki ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Limb Lengthening ◽  
Age Group ◽  
Entry Site ◽  
Excellent Outcome ◽  
Tibial Diaphysis ◽  
Institutional Review ◽  
Paediatric Age

Introduction- Tibial diaphysis fracture in paediatric age group accounts for 10 to 15% of all fractures. Fixation of tibial diaphysis fracture in paediatric age group by elastic nailing system provides relative stability. The purpose of this study is to evaluate the functional outcome of tibial diaphysis fracture in paediatric age group treated elastic nailing system. Methods- A prospective interventional study was conducted at Rapti Academy of Health Sciences, Ghorahi, Dang from November 2018 to November 2020. Ethical clearance was obtained from Institutional review board. All the children who were operated for tibial diaphysis fracture were followed up for six months. Final outcome was analyzed at final follow up. Results- Out of thirty children, there were sixteen male and fourteen female. Mean time of fracture union was 10.03 weeks. Two children develop limb lengthening of 1.5 cm and 1.2 cm respectively. One child had 1 cm shortening and three children develop bursitis on entry site. At final follow up 83.33% of child had an excellent outcome according to Flynn grading. Conclusion- Tibial diaphysis fracture can be treated with elastic nailing system with excellent to good functional outcomes.

EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari
Keyword(s):  
Burn Injury ◽  
Low Voltage ◽  
Care Center ◽  
Tertiary Care ◽  
The Body ◽  
Electrical Injury ◽  
Age Group ◽  
Electric Circuits ◽  
Medical College ◽  
Social Burden

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.

scholarly journals Birth tears after spontaneous and vacuum-assisted births with different vacuum cup systems – a retrospective cohort study

2020 ◽  
Vol 48 (6) ◽  
pp. 575-581
Author(s):  
Martina Kreft ◽  
Roland Zimmermann ◽  
Nina Kimmich
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Low Grade ◽  
Singleton Pregnancy ◽  
Perineal Tear ◽  
Vertex Presentation

AbstractObjectivesBirth tears are a common complication of vaginal childbirth. We aimed to evaluate the outcomes of birth tears first by comparing the mode of vaginal birth (VB) and then comparing different vacuum cups in instrumental VBs in order to better advise childbearing women and obstetrical professionals.MethodsIn a retrospective cohort study, we analyzed nulliparous and multiparous women with a singleton pregnancy in vertex presentation at ≥37 + 0 gestational weeks who gave birth vaginally at our tertiary care center between 06/2012 and 12/2016. We compared the distribution of tear types in spontaneous births (SBs) vs. vacuum-assisted VBs. We then compared the tear distribution in the vacuum group when using the Kiwi Omnicup or Bird’s anterior metal cup. Outcome parameters were the incidence and distribution of the different tear types dependent on the mode of delivery and type of vacuum cup.ResultsA total of 4549 SBs and 907 VBs were analyzed. Birth tear distribution differed significantly between the birth modes. In 15.2% of women with an SB an episiotomy was performed vs. 58.5% in women with a VB. Any kind of perineal tear was seen in 45.7% after SB and in 32.7% after VB. High-grade obstetric anal sphincter injuries (OASIS) appeared in 1.1% after SB and in 3.1% after VB. No significant changes in tear distribution were found between the two different VB modes.ConclusionsThere were more episiotomies, vaginal tears and OASIS after VB than after SB. In contrast, there were more low-grade perineal and labial tears after SB. No significant differences were found between different vacuum cup systems, just a slight trend toward different tear patterns.

scholarly journals Evaluation of the Anxiety Level of Mothers of Children with Epilepsy during the COVID-19 Pandemic Period

2021 ◽  
pp. 1-8
Author(s):  
Halil Celik ◽  
Sadettin Burak Acikel ◽  
Fatih Mehmet Akif Ozdemir ◽  
Erhan Aksoy ◽  
Ulkuhan Oztoprak ◽  
...  
Keyword(s):  
Neurological Disease ◽  
Chronic Conditions ◽  
Care Center ◽  
Tertiary Care ◽  
Anxiety Level ◽  
Childhood And Adolescence ◽  
Routine Examination ◽  
Significant Difference ◽  
Anxiety Levels

<b><i>Background and Aim:</i></b> Although anyone can be affected by the COVID-19 pandemic, it may cause additional concern for people with chronic conditions. Epilepsy is the most common neurological disease in childhood and adolescence. The aim of this study was to determine anxiety levels among the mothers of children under follow-up for epilepsy in our clinic during the COVID-19 pandemic. <b><i>Methods:</i></b> The study group consisted of the mothers of epilepsy patients who were under follow-up in the pediatric neurology outpatient clinic of the tertiary care center and were scheduled for a routine examination during the COVID-19 pandemic. The mothers’ anxiety levels according to the Beck Anxiety Inventory and their opinions about COVID-19 in relation to their child were assessed and compared based on whether the mother/patient attended their appointments in person and whether the child had frequent or infrequent seizures. <b><i>Results:</i></b> There was no statistically significant difference in anxiety level between the mothers of 64 children with epilepsy who attended their appointment during the pandemic and those of the mothers of 52 who did not attend their appointment. However, the mothers of children with frequent seizures had significantly higher anxiety levels. <b><i>Conclusion:</i></b> Anxiety level of mothers whose children have frequent seizures was significantly higher compared to mothers whose children have infrequent seizures. It is important to be aware about this point and using telemedicine approach in suitable population and postpone routine outpatient follow-up appointments as much as possible.

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