scholarly journals A prospective observational study of foetal outcome in twin pregnancy delivering at a tertiary health care center of South Gujarat

2021 ◽  
Vol 10 (3) ◽  
pp. 905
Author(s):  
Heny K. Jariwala ◽  
Falguni B. Patel ◽  
Minal R. Chaudhari ◽  
Anjani Shrivastava
Keyword(s):  
Twin Pregnancy ◽  
Care Center ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
P Value ◽  
Monochorionic Twins ◽  
Health Care Center ◽  
Increased Risk ◽  
Labour Room ◽  
Second Twin

Background: Worldwide increased incidence of twin gestation. The rates of twin gestation have a direct effect on the rates of preterm birth and its co-morbidities. Importantly, this increased risk applies to each fetus and is not simply the result of more foetuses.Methods: This prospective study was carried out in department of obstetrics and gynaecology. 100 consecutive subjects fulfilling inclusion criteria   admitted to labour room and obstetrics intensive care enrolled over a period of around 1 year.Results: In this study twin delivery accounted for 1.3% of all delivery at our institute. On analysing neonatal morbidities Prematurity was commonest 65%, VLBW (23% first twin, 30% second twin), RDS (9% first twin, 13% second twin), birth asphyxia (7% first twin, 12% second twin), neonatal hyperbilirubinemia (7% first twin, 8% second twin). 34% of first twin and 40% of second twin required NICU admission. Early neonatal death observed in 6% of first twin and 8% of second twin. It was observed that proportion of neonatal complications was more in MCDA as compared to DCDA and in un-booked subjects as compared to booked subjects. This difference is statistically significant among both twin (p value<0.05).Conclusions: Twin pregnancy is associated with high perinatal morbidity. Specialized obstetrics and Intensive Neonatal care can decrease neonatal morbidity and mortality in twin gestation. We need to be extra vigilant in monochorionic twins and twin pregnancy with inadequate antenatal care.

scholarly journals Knowledge and Awareness among mothers regarding exclusive breastfeeding in holy Karbala city / Iraq

2019 ◽  
Author(s):  
maytham salim Al-Nasrawii ◽  
Ali Neamah Al-Aaragi ◽  
Ali Abd Al-Latif G Mohammed
Keyword(s):  
Exclusive Breastfeeding ◽  
Care Center ◽  
Education Level ◽  
Environmental Benefits ◽  
World Health ◽  
Good Knowledge ◽  
P Value ◽  
Cross Sectional ◽  
Health Care Center ◽  
Significant Difference

Abstract Background: World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) “Exclusive breastfeeding (EBF)” is explained as “the infant receives only breast milk, no other liquids or solids. Its recommended for the first 6 months of life, and then complementary feeding should be started. EBF helps to reduce child morbidity and mortality from several diseases such as diarrhea, respiratory and /or ear infections and other infectious diseases, shielding lactation women from breast and ovarian cancer. In addition to offers societal economic and environmental benefits, The objective of this study was to assess the knowledge and awareness of exclusive breast feeding among mothers with a child < 2 years of age. Methods : A descriptive cross-sectional study was carried out in Health Directorate of Holy Karbala city. The study consist of (487) mothers how attendant to six Primary Health Care center (PHC). The collected data was done by direct interview with mothers and using a questionnaire form that designed based on the study objectives according to WHO criteria. Data were analyzed by SPSS, descriptive statistics included numbers (N) and percentage (%), and the inferential statistical test was done by using Chi-Square test , P-value was equal or less than 0.05 considered as statistically significant to find for any association between the results variables. Result : A total of 487 participants were included in the study, the rate of response was 92.7%. The highest percentage (66.3%) of study sample were full in the age group (21-30) years, and more than three quarters were lived in urban area. Nearly half of the study sample 47% had primary education and 60% those housewives, and the main source of information being family and friends (84.4%). As an overall assessment, 61.8% of the study sample had good knowledge and awareness about exclusive Breastfeeding, with highly significant differences to education level ,occupation residence of the mother. Conclusion: Over half of the subjects had good knowledge and awareness of exclusive Breastfeeding. And, on the other hand, there was a very significant difference between education level, occupation and mother's residence with a level of knowledge.

scholarly journals Electrolyte abnormalities in asphyxiated newborns

2018 ◽  
Vol 5 (3) ◽  
pp. 1036
Author(s):  
Satheesh Kumar D. ◽  
Thenmozhi M. ◽  
Kumar .
Keyword(s):  
Serum Sodium ◽  
Perinatal Asphyxia ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Postnatal Period ◽  
P Value ◽  
Sodium Potassium ◽  
Neonatal Deaths ◽  
Electrolyte Abnormalities

Background: Perinatal asphyxia is the most common cause of neonatal morbidity and mortality in worldwide. It accounts for 23% of all neonatal deaths. Electrolyte abnormalities are more common in the immediate post asphyxiated period and influence neonatal the outcome effectively. Aim of this study was to measure the serum sodium, potassium and calcium levels in immediate postnatal period of asphyxiated newborns and assess the correlation with different degree of birth asphyxia.Methods: The serum sodium, potassium and calcium levels were measured in asphyxiated newborns in the early post-natal period. Both intramural and extramural newborns were included irrespective of their mode of delivery but according to the Apgar score. The measured electrolyte values were compared with the different severity of asphyxia. Results: Out of 100 newborns 53 had hyponatremia, 10 had hyperkalemia and 3 had hypocalcemia. The serum sodium and potassium levels showed significant P value (<0.00) with the different degree of both asphyxia but calcium levels were not significant (p valve = 0.06). There was a negative linear correlation with sodium and calcium levels and positive correlation with the serum potassium levels.Conclusions: Hyponatremia was significant in all stages of birth asphyxia, hyperkalemia was significant with increased severity of birth asphyxia and hypocalcemia was only weakly significant even in severe birth asphyxia.

scholarly journals The impact of interpregnancy interval on occurance of preterm births in the present pregnancy

2021 ◽  
Vol 10 (5) ◽  
pp. 2020
Author(s):  
Balaji Thanjavur Elumalai ◽  
Vaishnavi Govindarajan
Keyword(s):  
Preterm Birth ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
P Value ◽  
Interpregnancy Interval ◽  
Maternal Characteristics ◽  
Increased Risk ◽  
Pregnancy Intervals ◽  
The Impact ◽  
Present Pregnancy

Background: The pregnancy outcomes are influenced by the inter pregnancy intervals. Both short and long inter pregnancy intervals are known to adversely affect the mother and the baby. The main aim of birth spacing was to achieve ideal inter pregnancy intervals and thus to decrease maternal, neonatal morbidity and mortality.Methods: It is a prospective observational study. In this study, about 500 gravida 2 women who has delivered vaginally in the index pregnancy, with gestational age more than 28 weeks of gestation and with known interpregnancy interval were included in the study. They followed up to to delivery and occurance of preterm births in relation to maternal characteristics and interpregnancy interval were analysed.Results: Our study showed that Inter pregnancy intervals of 18-24 months were found to have the least number of preterm births when compared to intervals <18 months and >24 months. This association was found to be statistically significant (p value, Pearson chi square 0.0008). This relationship between inter pregnancy intervals and preterm births persisted when stratified according to maternal age, education, residence and BMI.A previous preterm birth was associated with increased risk of recurrent preterm birth (p value -0.034) and was statistically significant. The history of PROM in present pregnancy associated with preterm birth (p value -0.001) and association was statistically significant.Conclusions: From this study it was found that the 18-24 months birth to pregnancy interval is associated with the least incidence of preterm births. 

Fasting in Ramadan is safe for Individuals Suffering from Type 2 Diabetes Mellitus in Pakistan

2020 ◽  
Author(s):  
Fatima Jehangir
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Care Center ◽  
P Value ◽  
Risk Category ◽  
Drug Induced ◽  
Ramadan Fasting ◽  
Health Care Center

Background: Whether diabetics should fast or not in Ramadan has been a controversial idea since long and the answer even more debatable. It confers safety measures to be known by the diabetics thoroughly, such as when to break the fast and what the hypoglycemic cut offs are. We aimed to determine hypoglycemic events and safety of Ramadan fasting among individuals with Type 2 Diabetes Mellitus (DM). Methods: This was an observational study enrolling diabetics who decided to fast in Ramadan, were aged >18 years, visited the primary health care center in Sikanderabad and Clifton clinic and gave consent to participate in the study. The exclusion criteria was Type 1 Diabetes Mellitus, Gestational diabetes, drug induced Diabetes and Maturity Onset Diabetes of the Young. A total of 103 participants were included in the study. Data was captured pre-Ramadan, during Ramadan and post-Ramadan in the year 2019. Multivariate Logistic regression was computed and chi-square taken for association of risk factors with hypoglycemia. P-value <0.05 was considered significant. Results: Mean HbA1c before Ramadan was 9.2%+2.1 and after Ramadan 7.7%+1.4 (P-value<0.05) showing a reduction of 1.5%. Mean weight of the patients before Ramadan was 68.3kg+1.6 and during Ramadan 64.8kg+1.4(p-value <0.00) showing a dip of 3.5 kg however mean weight 1 month after Ramadan was 66.5kg+14.9 depicting a rise again of 1.8kgs. Higher the risk category of American Heart Association, those who had hypoglycemic events before Ramadan and those on basal-bolus combination insulin had more hypoglycemic events (p-value <0.05). Conclusion: Fasting in Ramadan shows a major reduction in weight (3.5kg) as well as corrects hyperglycemia (1.5%). However, hypoglycemia was attributed to high risk patients only hence Ramadan fasting proved to be quite safe in individuals with Type 2 DM.

Efficacy of Liraglutide: GLP 1 Receptor Agonist on Glycemic Control and Weight Loss among Patients with Type 2 Diabetes

2020 ◽  
Author(s):  
Fatima Jehangir
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Glycemic Control ◽  
Care Center ◽  
Standards Of Care ◽  
P Value ◽  
Diabetic Patients ◽  
Health Care Center ◽  
The Impact

Background: American Diabetes Association (ADA) made conspicuous changes in its 2019 Standards of Care Diabetes guidelines by choosing Glucagon like Polypeptide 1 (GLP1) receptor agonists and Sodium Glucose co-transporter 2 (SGLT2) inhibitors as the second line treatment options after metformin because both classes of drugs are cardiovascular friendly as proved in the Cardiovascular Outcome Trials (CVOT) trials. GLP analogs show massive weight loss benefits apart from offering good glycemic control. We aimed to determine the impact of liraglutide on correction of hyperglycemia and body weight in Asian population. Methods: A cross sectional pre-post observational study enrolling 49 Type 2 diabetic patients with uncontrolled blood glucose, 15 years and above who agreed to use liraglutide apart from standard care, for glycemic control were recruited in the study. Study site was general practice clinic in Clifton and family medicine health care center Ziauddin University. Pre and post treatment HbA1C and BMI were observed after adding on Liraglutide 1.8 mg to metformin 1 gm bid, over a period of 12 weeks. Differences in the changes in BMI and HbA1C were examined using McNemar’s test. Results: Mean age of the participants was 44.4 years. Duration of Diabetes was 65.1 months i.e. 5.4 years. At week 12, liraglutide 1.8 mg significantly reduced HbA1C levels by 0.94% (8.53+1.07 vs. 7.56+1.04 p-value <0.05) and BMI by 6.2kg (37.23+ 5.3 vs. 31.27.6+5.5 p-value <0.05) statistically significant. Conclusion: Liraglutide 1.8 mg over a period of 12 weeks, significantly reduced body weight (6.2kg p-value 0.05) and improved glycemic control (0.94% p-value<0.05) without causing hypoglycemia.

MECONIUM STAINED LIQOUR AND ITS IMPACT ON PERINATAL OUTCOME

2021 ◽  
pp. 47-49
Author(s):  
Ranjana Sharma ◽  
Manju Agarwal
Keyword(s):  
Prospective Observational Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission ◽  
One Year

Background- The occurrence of meconium-stained amniotic uid (MSAF) during labor has long been considered the predictor of adverse fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia, which leads to perinatal and neonatal morbidity and mortality Methods- A Prospective observational study was carried out in Smt. Hira Kunwar Ba Mahila Hospital, Jhalawar attached to Jhalawar Medical College,over one year from January 2020 to January 2021. Total 278 cases taken at random basis having following inclusion criteria Result- MSL is responsible for neonatal morbidity in 15.1% of cases. Rate of neonatal morbidity was higher in thick meconium group (24.9%) as compared to thin meconium group (6.2%) and this difference was statistically signicant. In our study birth asphyxia (5.8%) was the most common complication followed by MAS (4%), Pneumonitis (3.6%) and Sepsis (1.8%). Conclusion- Passage of meconium still remains as an enigma to the obstetrician and equally worries the paediatrician. As shown in the study, thick meconium is associated with increased operative intervention, low apgar score, increased rate of NICU admission and increased risk of neonatal morbidity and mortality as compared to thin meconium.

Association between CHA2DS2-VASc score and in-hospital death in ICU patients with COVID-19

2021 ◽  
Vol 4 (4) ◽  
pp. 595-600
Author(s):  
Mukesh Jha ◽  
Utkarsh Mukesh Balani ◽  
Vimlesh Pandey ◽  
Prachi Balani ◽  
Vipin Patel ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Blood Cells ◽  
Care Center ◽  
White Blood Cells ◽  
Hospital Death ◽  
P Value ◽  
Icu Patients ◽  
Health Care Center ◽  
Significant Difference ◽  
Discharged Patients

Background: CHA2DS2-VASc score is a scientifically proven risk assessment score for patients with atrial fibrillation. It may be a good predictor of in-hospital death in COVID-19 patients. The present study aimed to evaluate the association between CHA2DS2-VASc score and in-hospital mortality in the prognosis of intensive care unit (ICU) patients with COVID-19. Methods: Eighty-four COVID-19 patients who were hospitalized in the ICU were retrospectively analyzed in a tertiary health care center, and the CHA2DS2-VASc score was determined. All analyses were performed using SPSS statistical software (SPSS Inc., Chicago, IL, USA, 20.0). A p-value <0.05 was considered statistically significant. Results: The median age of patients was 60.0 years, and most were males (75.0%). Findings of the study showed that the CHA2DS2-VASc score was considerably higher among the hospitalized patients than discharged patients (3.08 ± 1.72 vs. 1.38 ± 1.16; p<0.001), and patients who required mechanical ventilation compared to those who did not require mechanical ventilation (3.03 ± 1.68 vs. 1.15 ± 0.97; P <0.001), respectively. Patients with CHA2DS2-VASc score of ≥3 had substantially higher age [67(45-87) vs. 58(19-75); P ˂0.001], computed tomography involvement score [67.5(20-90) vs. 35(15-90); P ˂0.001] and need for mechanical ventilation [29(90.6%) vs. 22(42.3%); P ˂0.001]. A significant difference was found in oxygen saturation on admission (P =0.001) between the two groups. In-hospital death was significantly higher among patients with a CHA2DS2-VASc score of ≥3 (P <0.001). The CHA2DS2-VASc score was positively correlated with white blood cells count (r=0.257, P =0.018) and negatively correlated with the number of days spent in the hospital (r=-0.184, P=0.130) due to higher in-hospital death in ICU patients with COVID-19. Conclusion: CHA2DS2-VASc score may be an effective tool to estimate in-hospital death in COVID-19 patients who were hospitalized in the ICU.

scholarly journals Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

2017 ◽  
Vol 6 (3) ◽  
pp. 1030 ◽  
Author(s):  
Dharna Desai ◽  
Nandita Maitra ◽  
Purvi Patel
Keyword(s):  
Heart Rate ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
P Value ◽  
Meconium Staining

Background: This study assesses the role of abnormal fetal heart rate tracing patterns in patients with thick meconium staining of the amniotic fluid and its association with perinatal outcomes.Methods: Prospective unmatched case-control study on 2 groups of 136 subjects each- cases had thick MSAF and controls had clear liquor with abnormal fetal heart rate tracings on cardiotocography.Results: Gestational age (GA) >40 weeks, was found to have a significant association with MSAF (p value 0.01556 CI 95%). Premature Rupture of membranes at term (PROM) showed a significant association with MSAF with an OR of 2.25 (95% CI 1.37, 3.7); Post datism had significantly higher odds for being a risk factor for MSAF with an OR (3.194) (CI 95% 1.003-10.165). MSAF was not found to be significantly associated with abnormal trace on CTG. Neonatal morbidity (MAS, birth asphyxia, sepsis, HIE) had statistically higher odds in cases 1.669 (0.884-3.150) as compared to controls.Conclusions: No particular cardio-tocograph pattern can be considered to have a poor prognostic value in the presence of thick MSAF and the decision to deliver and the mode of delivery should be based on the overall assessment and the stage and progress of labor. While management should be individualized, a higher Caesarean section rate in thick MSAF can be justified to ensure a better outcome for the neonate even in the presence of a normal CTG trace.

scholarly journals Microbial Flora in Chronic Periodontitis: Study at a Tertiary Health Care Center from North Karnataka

2015 ◽  
Vol 7 (01) ◽  
pp. 049-054 ◽  
Author(s):  
Kirtilaxmi K Benachinmardi ◽  
Jyoti Nagamoti ◽  
Shaila Kothiwale ◽  
Sharada C Metgud
Keyword(s):  
Chronic Periodontitis ◽  
Care Center ◽  
Antibiotic Sensitivity ◽  
Public Health Problem ◽  
Clinical Samples ◽  
P Value ◽  
Oral Microbiota ◽  
Major Public Health Problem ◽  
Culture Methods ◽  
Health Care Center

ABSTRACT Background and Objective: Periodontitis is a major public health problem in India with a prevalence of 60-80%. If untreated it acts as a risk factor for systemic diseases. Data on anaerobic periodontal microflora in the Indian population is very scarce. Hence, this study was undertaken to know the nature of oral microbiota in chronic periodontitis in this region of India and also the semiquantitative study in pre- and post-treatment group and to determine antibiotic susceptibility pattern for aerobic isolates. Materials and Methods: The present study was conducted on 60 cases. Material was collected from the subgingival pockets in patients with chronic periodontitis attending the Periodontology, Outpatient Department. Clinical samples were transported to the laboratory in fluid thioglycollate medium. Initially Gram's stain and Fontana stains were done. Aerobic, anaerobic, and microaerophilic culture were put up. Antibiotic sensitivity test was done for aerobic isolates. Results: Sixty samples yielded 121 isolates of which 78.34% were polymicrobial, 11.66% were monomicrobial and oral commensals were grown in 10% cases. Out of 121 isolates 91.74% were anaerobic, 7.43% were aerobic and 0.83% were microaerophilic. Fusobacterium species was the most common isolate among anaerobes. Using "paired t-test" "P" value was significant indicating significant reduction in colony count after phase-I periodontal therapy. Conclusion: This study has shown that anaerobic bacteria are important cause of chronic periodontitis, along with aerobes and microaerophilic organisms. Fusobacterium spp, Bacteroides fragilis, Porphyromonas spp and Prevotella intermedia are the most common anaerobic pathogens. Bacterial culture methods are still economical and gold standard.

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