scholarly journals Role of dinoprostone gel in induction of labour

2021 ◽  
Vol 10 (3) ◽  
pp. 1017
Author(s):  
Meet S. Patel ◽  
Shashwat K. Jani ◽  
Babulal S. Patel ◽  
Akshay C. Shah
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Western India ◽  
Group I ◽  
First Choice ◽  
Acceptable Method ◽  
Group Ii

Background: Labour induction is one of the most common intervention in obstetric practice. A simple application of PGE2 intracervical gel can ripen the cervix effectively and improve Bishop’s score there by helping in successful vaginal delivery. Considering its good performance, the dinoprostone slow-release vaginal insert is the first choice for elective induction of labour in postdate pregnancy and in patients with term pregnancy of premature rupture of membranes.Methods: This was a single year retrospective study conducted in a tertiary care center of western India from May 2019 to May 2020.Results: In group I women who delivered within 24 hours were included, in group II women who required re-instillation were included. The most common indication for induction in both the groups was past dates (accounting for 36.1% in group I and 47.3% in group II). The success rate in group I was 68.1% while in group II was 36.8%.  The rate of cesarean delivery in group I was 25.9%, while in Group II, it was 60.1%. Negligible maternal and neonatal complications were seen in both the groups.  Conclusions: The study showed that intracervical application of prostaglandin E2 is an effective, safe and acceptable method for induction of labor in women with unfavorable cervix and indications for induction. All these effects were achieved without increasing maternal and neonatal morbidity 

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

The Significance of Uvula After Palatoplasty

2017 ◽  
Vol 55 (3) ◽  
pp. 451-455 ◽  
Author(s):  
Ahmed Elsherbiny ◽  
Ahmed S. Mazeed ◽  
Samia Saied ◽  
John H. Grant
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
New Technique ◽  
Aesthetic Outcome ◽  
Group I ◽  
Aesthetic Results ◽  
Palate Repair ◽  
Group Ii ◽  
A New Technique ◽  
The Aesthetic

Objective: This study aims to examine the importance of the uvula as a part of palatoplasty outcome and to assess the aesthetic results of the conventional versus a new technique for uvuloplasty. Design/Participants: The study included 2 groups of patients undergoing palatoplasty. Group I consisted of 20 cleft palate patients repaired with the conventional uvula repair, combining the 2 hemi-uvulae. Group II consisted of 20 patients repaired with our new technique, sacrificing one hemi-uvula and centralizing the remaining one. The aesthetic outcome was assessed in both groups. A questionnaire was distributed to the families of both groups to assess their concern about the uvula after palate repair. Setting: Cleft unit at a tertiary care center. Results: Sixty-five percent of parents considered the uvula as important functionally and aesthetically after palate repair whereas 35% either did not care or were not sure about its importance. Results of the aesthetic outcome of the 2 techniques for uvula reconstruction showed that uvula was absent in 4 cases in group I versus 1 in group II ( P > .05), small in 8 cases of group I versus 4 in group II ( P > .05), bifid in 5 cases of group I versus none in group II ( P < .05), became deviated in no case of group I versus 4 in group II ( P > .05), and was satisfactory in 3 cases of group I versus 11 in group II ( P < .05). Conclusions: Among the respondents, the uvula was a significant concern to the parents of cleft patients and should be given more attention during repair. The described technique had better aesthetic outcome over the conventional one of combining the 2 hemi-uvulae.

scholarly journals Comparison of Two Protocols for Management of Placenta Accreta at a Tertiary Care Center in Pakistan

2017 ◽  
Vol 9 (1) ◽  
pp. 18-24
Author(s):  
Rubina Izhar ◽  
Samia Husain ◽  
Suhaima Tahir ◽  
Sonia Husain
Keyword(s):  
Placenta Accreta ◽  
Care Center ◽  
Tertiary Care ◽  
Massive Hemorrhage ◽  
Tertiary Care Center ◽  
Group I ◽  
Key Factor ◽  
The Mean ◽  
Group Ii ◽  
Placenta Accrete

ABSTRACT Objectives To evaluate the morbidity of placenta accreta when managed by two different protocols. Materials and methods All women with placenta accreta coming to Abbasi Shaheed Hospital were included and divided in two groups. Group I included all women with accreta who were managed by lower segment transverse incision in the year 2013. Group II included all women whose accreta was dealt with classical incision in the year 2014. Morbidity from placenta accreta in all these cases was assessed. Results A total of 4220 deliveries took place during study. Placenta accrete was diagnosed in 24 cases (incidence = 0.0056%). Mean age of patients in group II was 28.58 ± 3.28 years and in group I was 29.75 ± 2.18 years. Blood products were received by 9(75%) patients in group I, and by 1(8.33%) in group II (p = 0.002). Intensive care unit admissions in group I were 75% and 25% in group II (p = 0.014). Renal sequelae occurred in 7 women in group I (58.3%) whereas none were observed in group II (p = 0.002). The mean duration of hospital stay was 9.83 ± 2.95 days in group I and 2.75 ± 1.215 days in group II. Conclusion Prevention of massive hemorrhage is the key factor in reducing maternal morbidity in placenta accreta cases. Clinical significance Dealing with accreta via midline incision in low resource settings leads to reduced morbidity. How to cite this article Izhar R, Husain S, Tahir S, Husain S. Comparison of Two Protocols for Management of Placenta Accreta at a Tertiary Care Center in Pakistan. J South Asian Feder Obst Gynae 2017;9(1):18-24.

scholarly journals The Role of Low Dose Misoprostol in Cervical Ripening and Induction of Labour Beyond the Age of Viability and its Effects on Maternal and Fetal Outcomes

JMS SKIMS ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 18-21
Author(s):  
Humaira Ali ◽  
Cimona Lyn Saldanha ◽  
Tabasum Parveiz ◽  
Rabia Khurshid
Keyword(s):  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
P Value ◽  
Delivery Time ◽  
Fetal Outcomes ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii ◽  
Vaginal Misoprostol

This study was conducted to compare the efficacy and safety of oral (50 μg) and vaginal (25 μg) misoprostol for cervical ripening and induction of labour. Two hundred patients with indications for labour induction randomly received either 50 μg oral misoprostol every 4 h (Group-I) or 25 μg vaginal misoprostol every 4 h (Group-II), for maximum of six doses. Mean induction to delivery time, delivery within 24 hrs, mode of delivery, oxytocin use, number of doses used, failed induction rate and maternal complication and fetal outcomes were compared for the two groups. Mean induction delivery time was significantly longer in Group-I (20.55±5.59 hrs) than in Group-II (16.70±7.12 hrs) (with mean difference of 3.85 and P-value of <0.001). Mean number of doses of misoprostol used for oral and vaginal misoprostol study populations were 2.61±0.94 and2.37±1.20respectively. Oxytocin augmentation was required in significantly more number of patients in oral group (80%) than in vaginal group (68%) with P-value of 0.027. There were 3 failed inductions in the oral and 4 in the vaginal group after a total of six doses of misoprostol. Incidence of maternal and fetal complications was similar between two groups. Our findings indicated that, 25μg vaginal misoprostol has the potential to induce labor as safely as, and more effectively than, 50 μg oral analogue. JMS 2017; 20(1):18-21

scholarly journals A comparative study between laparoscopic and open cholecystectomy in cases of cholecystitis with cholelithiasis: one year experience in tertiary care center

2017 ◽  
Vol 4 (3) ◽  
pp. 903 ◽  
Author(s):  
Ashutosh Shukla ◽  
Sharad Seth ◽  
Alok Ranjan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Open Cholecystectomy ◽  
Care Center ◽  
Tertiary Care ◽  
Gall Stone ◽  
Treatment Strategies ◽  
Group I ◽  
Duration Of Surgery ◽  
Group Ii

Background: Gall stones are a major cause of morbidity all over the world. Until the end of 1980’s, open cholecystectomy was the gold standard for treatment of stones in the gall bladder. Laparoscopy has revolutionized surgery causing a re-evaluation of treatment strategies including cholecystectomy, however, it is not completely devoid of pitfalls. This study was undertaken to determine whether laparoscopic cholecystectomy can be recommended over open cholecystectomy as the procedure of choice for the treatment of cholecystitis with cholelithiasis.Methods: This study included a total of 100 patients in the age group 20-70 years diagnosed as calculous cholecystitis on ultrasonography and admitted to the surgical wards of Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India between November 2014 to October 2015. They were divided into two groups. Group I (n = 50) who underwent laparoscopic cholecystectomy and Group II (n = 50) who underwent open cholecystectomy.Results: A comparison of the two groups showed that the duration of surgery was significantly more in Group I (mean 52.32 minutes) as compared to Group II (mean 37.66 minutes) (p <0.001). There was <100 ml blood loss in the majority of Group I cases (94%), however, in Group II, majority had blood loss ≥100 ml (96%) (p <0.001). Mean duration of post-operative pain was 14.68 hours in group I and 27.92 hours in group II (p <0.001). Time taken to restoration of oral feeds, was less in group I (mean 11.68 hours) as compared to group II (mean 17.24 hours). Post-operative hospital stay was a mean of 1.18±0.52 days in Group I and a mean of 4.78±1.42 days in Group II (p<0.001). The time taken for resumption of normal activity was two days and three days (p <0.001) in group I and II respectively. In Group I, average cost of treatment was rupees 10870, but in Group II it was significantly more at rupees 12152 (p = 0.007).Conclusions: Laparoscopic cholecystectomy as a surgical procedure can be recommended over open cholecystectomy in carefully selected patients of gall stone disease.

scholarly journals Prevalence of anaemia among children under five years in tertiary care hospital of Nepal.

2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Care Hospital ◽  
Cross Sectional ◽  
Children Under Five ◽  
Group Iii ◽  
Under Five ◽  
Group I ◽  
Group Ii

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998

scholarly journals A randomised trial of 5% minoxidil versus combination of 5% minoxidil and oral spironolactone in treatment of female pattern hair loss

2019 ◽  
Vol 5 (4) ◽  
pp. 668
Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu
Keyword(s):  
Combination Therapy ◽  
Hair Loss ◽  
Tertiary Care ◽  
Randomised Trial ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Female Pattern Hair Loss ◽  
Group I ◽  
Topical Minoxidil ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>

scholarly journals Report of a Case of Cold Urticaria Following Cryotherapy – Need for Screening for Untoward Effects of Cryotherapy in Physical Therapy Clinical Practice

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Mohanakrishnan Jagadevan ◽  
Bhanumathy Mohanakrishnan ◽  
Gopisankar Balaji ◽  
Malathi Munisamy ◽  
Salaja Murugesan ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Health Care Professionals ◽  
Physical Therapist ◽  
Care Center ◽  
Tertiary Care ◽  
Cold Urticaria ◽  
Screening Process ◽  
Cold Stimulation ◽  
Systemic Complications ◽  
First Choice

Introduction:Musculoskeletal rehabilitation is one of the frontline domains in physical therapy practice. In most countries, physical therapists prefer independent practice with referrals from general practitioners and orthopedic surgeons. Under these circumstances, the physical therapist may be the first contact professional handling these individuals who may not have adequate medical records with their personal medical history. Cryotherapy for pain relief could be the first choice of pain management opted by a musculoskeletal therapist. That is when both the therapist and the patient have to be aware of the undesirable effects of cryotherapy application and its potential local and systemic complications. The outcome of this paper could be an initiative for a standardized screening process to be incorporated into physical therapy practice. Clinical Findings:A 30-year-old man with left knee pain who underwent exercise therapy in the physiotherapy unit of a tertiary care center developed erythematous rashes around the knee following ice application. It was noted that the patient was not aware of the same in the past. The patient was attended by a dermatologist, and a diagnosis of cold urticaria was made following confirmation with cold stimulation test. Conclusion:From this study, it may be concluded that the awareness of cold-induced urticaria has to be emphasized on both patients and health care professionals. A simple screening protocol should be made mandatory in orthopedic physical therapy practice, which would suffice this purpose. Keywords: Urticaria, cryotherapy, Physical therapy

scholarly journals Maternal Attitude and Knowledge towards Modes of Delivery

2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Cross Sectional ◽  
Medical College ◽  
Acceptable Method

Background: Whether a mother should be allowed to choose between the modes of delivery is a matter of concern among practicing obstetricians. This study aims to explore the knowledge of the Nepalese women attending a tertiary care center about the benefits and complications of vaginal and caesarean delivery and their attitude and preference for the method of delivery.Methods: The study was a hospital based cross sectional questionnaire survey conducted in Nepal Medical College teaching Hospital, Jorpati from 1stShrawan 2074 to 31st Ashoj 2074. All pregnant women who were 36 weeks or more in gestation attending the clinic during the study period were included in the study. A questionnaire was made of 10 questions for knowledge assessment regarding mode of delivery consisting of the indications, the possible complications and advantages of vaginal and caesarean delivery. Results: A total of 256 pregnant women participated in the study. The knowledge of the mode of delivery, their benefit and complications was medium to good in approximately 90% of the mothers attending the antenatal OPD. Overall attitude for vaginal delivery was positive in 93% of women and negative or neutral in 6.6%.Overall attitude for caesarean delivery was positive in 24% and negative or neutral in 75.8%.Conclusions: Women in our setup agree that vaginal delivery is a natural and acceptable method of delivery and would prefer to have a vaginal delivery. Keywords: Attitude; knowledge; modes of delivery; women.

Sign in / Sign up

Export Citation Format

Share Document