scholarly journals Analysis of indication of caesarean sections according to Robson’s ten group classification system at a tertiary care teaching hospital in South Rajasthan

2021 ◽  
Vol 10 (3) ◽  
pp. 1106
Author(s):  
Saroj Saharan ◽  
Radha Rastogi ◽  
Deepti Chyaunal
Keyword(s):  
Teaching Hospital ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
Obstetrics And Gynecology ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Medical College ◽  
Group 5 ◽  
Group 2

Background: The objective of this study was categorization and evaluation of the caesarean section rate at our institute as per Robson’s formula.Methods: This retrospective study was conducted at department of obstetrics and gynecology, RNT Medical college, Udaipur, a tertiary care teaching hospital in South Rajasthan. The data was collected retrospectively from December 2020 to February 2020 over a period of 2 months and percentage were calculated in various groups as per Robson’s ten group classification system.Results: Among a total of 1195 women delivered during study period, 420 (35.14%) delivered by CS. Women with previous CS (group 5) contributed maximum (35.95%) to the total number of CS followed by group 2 (27.14%).Conclusions: Standardization of indication of caesarean deliveries, regular audits and definite protocol in hospitals will aid in curbing the rate of caesarean deliveries in hospitals.  

Knowledge, Attitude and Practices of Pharmacovigilance among Doctors at a Tertiary Care Teaching Hospital Birgunj, Nepal

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
Smita Singh ◽  
Deependra Prasad Sarraf ◽  
Prabin Singh ◽  
Pragati Poudyel
Keyword(s):  
Teaching Hospital ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Medical College ◽  
National Medical

Introduction: Pharmacovigilance helps in the detection and prevention of adverse effects of drugs. For the effectiveness of this program, health care professionals should report adverse drug reactions (ADRs) considering it as their moral and professional obligation. The objective of the study was to assess the knowledge, attitude, and practices (KAP) of the doctors towards ADRs and pharmacovigilance in  National Medical College Teaching Hospital (NMCTH), a tertiary care teaching hospital situated in the Narayani zone. Materials and Methods: A cross-sectional study was carried out using a self-administered questionnaire consisting of four parts; first part included a demographic profile of participants, the second part consisted of ten questions for the assessment of the knowledge about pharmacovigilance, third part comprised of six questions on attitude and fourth part consisted of five questions on practice. The results were depicted in the form of percentages for each KAPs questionnaire.   Results: The response rate of participants was 85.16%. Pharmacovigilance was correctly defined by 52%. Department of drug administration was responsible for monitoring ADRs in Nepal was correctly given by 80%. Only 8% had reported ADRs, although 62% had encountered an ADR in their clinical practice. Conclusion: The doctors at NMCTH had a poor KAP towards pharmacovigilance and educational intervention is needed for the proper functioning of this program.

Incomplete abortion following medical method of abortion: study at a tertiary care teaching hospital at Bihar

2020 ◽  
Vol 9 (12) ◽  
pp. 4903
Author(s):  
Pushpa .
Keyword(s):  
Health Care Providers ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Care Providers ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Medical College ◽  
Incomplete Abortion ◽  
Comprehensive Abortion Care ◽  
One Year

Background: Medical method of abortion (MMA) is a safe and effective method of abortion. Combination of mifepristone and misoprostol is most widely used. However, this is being randomly used by women without proper prescription which can lead to life threatening complications.Methods: This is an observational study done at Patna Medical College and Hospital, Patna, a tertiary care teaching hospital in Bihar, in a period of one year from March 2019 to February 2020. This is an attempt to study incomplete abortion after medical method of abortion and to observe the method of taking it among patients, with prescriptions or without it. Hundred women with incomplete abortion following MMA in 1st trimester of pregnancy were included. Patients’ age, parity, gestational age, locality, complaints, complications and treatment were noted. An information regarding method of administration and prescription noted.Results: 96% women used combined mifepristone plus misoprostol drug. Only 12% took the medicine on prescription of MBBS doctor, rest were all either self-administered or advised by quacks. Blood transfusion was required in 60% patients.Conclusions: Medical method of abortion is safe and effective but complications can occur if not used in accordance with guidelines. Women should be taught about and motivated for contraception. Adequate training to health care providers about comprehensive abortion care should be given.

scholarly journals Analysis of Caesarean Section Rates Using the Robson Ten-group Classification at a Tertiary Care Teaching Hospital in Eastern India: A Cross-sectional Study

2021 ◽  
Author(s):  
Hiralal Konar ◽  
Madhutandra Sarkar ◽  
Sisir Kumar Chowdhury
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Relative Size ◽  
Group Classification ◽  
Cross Sectional ◽  
Care Teaching ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Introduction: The Robson ten-group classification identifies the women’s groups that make the greatest contribution to the overall rate of Caesarean Section (CS), and thereby helps to optimise CS rates. It also helps to ensure optimum maternal and perinatal outcomes. Aim: This study was undertaken to examine the rates of CS using the Robson ten-group classification, and also to identify the women’s groups that contribute most to CS rates in a tertiary care teaching and referral hospital in Kolkata, India. Materials and Methods: This cross-sectional observational study was conducted over a period of one year from May 2012 to April 2013. All pregnant women admitted under the supervision of a particular unit of the Department of Obstetrics and Gynaecology and delivered in that hospital during the study period were included. Necessary data collection was done on the following parameters, i.e., previous obstetric history, category of pregnancy, course of labour and delivery, and gestational age. The women were categorised into the ten Robson groups. For each group, the CS rate, relative size of the group, and the percentage contribution made by the group to the overall CS rate were calculated and expressed in percentages. Chi-square test, Z-test and the trial version of Statistical Package for Social Sciences (SPSS) version 20.0 were used to analyse the data. Results: The CS rate in the present study was 43.13% (735 out of 1704 deliveries). Not only the largest group in terms of relative size 649 (38.08%), the Robson group 1 had a CS rate of 41.75% (271/649), as well as the largest absolute number of caesarean deliveries. The group 1 made the largest contribution (271) to the overall CS rate (15.9%). The group 5 was the second largest contributing group 155 (9.09%), followed by group 3 96 (5.63%) and group 2 69 (4.04%). In the present study group 5 showed the CS rate of 95.67%, group 3 with CS rate of 24.48% and group 2 with CS rate of 60.52%. Conclusion: The Robson groups 1, 2, 3 and 5 were found to be the major contributors to the overall CS rate. These groups may be targeted for effective interventions to reduce the CS rate. Active management of labour in a primigravida with spontaneous onset, reduction of primary caesarean delivery, promoting vaginal birth after CS, and careful assessment of cases before induction of labour in nulliparous women, are likely to be few effective strategies.

Prescribing Pattern of Drugs in Department of Obstetrics and Gynecology at A Tertiary Care Teaching Hospital, Bangalore, India

2021 ◽  
Vol 15 (5) ◽  
pp. 1265-1269
Author(s):  
F. Makiabadi ◽  
Rajeswari R R ◽  
Jayashree AK
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Antifungal Drugs ◽  
Obstetrics And Gynecology ◽  
Case Report Form ◽  
Prescription Pattern ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Standard Set

Objective: To assess the drug prescription pattern in the department of obstetrics and gynecology At A Tertiary Care Teaching Hospital, Bangalore, India. Methodology: A prospective observational study on Drug Utilization pattern was done in the department of Obstetrics and Gynecology of a 950 bedded tertiary care teaching hospital in Bangalore for 6 months. All patients were admitted to the Department of Obstetrics and Gynecology. Patients satisfying Inclusion criteria were enrolled after obtaining Informed Consent. Patient data entered into Case Report Form (CRF). Medication orders were observed for Prescription patterns. WHO Prescription indicators will be used to study the number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic, percentage of encounters with an injection, percentage of drugs prescribed. Result: A total of 120 cases were collected. A total of 1004 drugs were prescribed which included 244 (24.30%) minerals and vitamin supplements, 219 (21.81%) Antibiotics, 146 (14.55%) Gastric acid Secretion Inhibitors, 108(10.75%) Analgesics, 35 (3.49%) Antihypertensive drugs, 22 (2.19%)Antifungal drugs, 32 (3.19%) Anti-diabetic drugs, 32 (3.19%) Anti-spasmodic, 41 (4.08%) Antiemetic drugs, 12 (1.19%) Corticosteroids, 16 (1.59%) Anticonvulsant drugs, 97 (9.66%) in the category of “Others”: Anti sceptics, Topical agents, Oxytocic, Antihyperlipidemic drugs, Oral contraceptives, etc. Percentage of Drugs used in different categories were, In our study majority of drugs from Category A (45.405), Category B (35.63%), Category C (16.67%), Category D (2.30%). the average number of drugs per prescription in this study (8.36) is higher than the standard set by WHO (1.6-1.8), percentage of patients prescribed with Injectables is 39.70% this is also high when compared with the range of the standard set by WHO. Conclusion: The results of our study highlight several areas that need improvement, most importantly there is Polypharmacy was practiced as the average number of drugs (8.36) per prescription when compared with a standard set by WHO. Another area that is Percentage of drugs prescribed by Generic name is also low which also need to improve. Iron, Calcium, and Folic acid were the most frequently prescribed drugs. Overall drug use pattern is rational with few exceptions which were mentioned above. The majority of the drugs were prescribed from the Essential Medicine List and the majority of drugs were prescribed as per FDA Category A the Safest Category during pregnancy. Keywords: prescription pattern, Obstetrics, Gynecology

scholarly journals A study assessing patient satisfaction in otolaryngology OPD of a district medical college of West Bengal

2019 ◽  
Vol 6 (3) ◽  
pp. 1247
Author(s):  
Shamima Yasmin ◽  
Tanmay Kanti Panja ◽  
Baijayanti Baur
Keyword(s):  
Drinking Water ◽  
Patient Satisfaction ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Cross Sectional ◽  
Registration System ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Medical College

Background: Patient satisfaction is perhaps is a proxy indicator to measure the success of a hospital. The aim of this study was to evaluate the level of patient satisfaction among patients attending Otorhinolaryngology outpatient department (OPD) of a tertiary care teaching hospital in a district.Methods: Cross-sectional observational study among 230 patients attending Otorhinolaryngology outpatient department (OPD) of a tertiary care teaching hospital in a district using a modified validated Bengali questionnaire. Analysis of results was done by percentage and proportion.Results: Overall satisfaction was above 60% for only 42.6% of patients. Major dissatisfaction was with the registration system. 50.4% were dissatisfied for waiting at the queue of registration counter to get OPD ticket. Other causes of dissatisfaction were infrastructure e.g. non-availability of adequate seating arrangement (39.6%), fans (58.7%), non-availability of drinking water (71.7%). 78.3% were dissatisfied for the available washroom facilities. However 92% were satisfied by attention paid by doctors.Conclusions: The present study was an attempt to assess the level of satisfaction of the patients. It highlights maintaining privacy during history taking examination and improving infrastructure like drinking water and washroom facilities, improving registration system to decrease waiting time can improve patient satisfaction which can be easily done with help of stakeholders.

scholarly journals A Study on Detection of Drug-Laboratory interactions in Dermatology, in a Tertiary Care Teaching Hospital

2020 ◽  
Vol 13 (4) ◽  
pp. 350-355
Author(s):  
M. Sreenivasulu ◽  
K. Sivaiah ◽  
V.Jagadeesh Naik
Keyword(s):  
Drug Interactions ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
American Psychological Association ◽  
Educational Interventions ◽  
Environmental Chemical ◽  
Dermatology Department ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Medical College

Background: An interaction is alleged to occur once the consequences of one drug is changed by the presence of another drug, herbal medicine, food, drink or by some environmental chemical agents. As per American psychological association drug interaction is defined as chemical or physiological reaction that can occur when two different drugs are taken together. Objective: This study was conducted for the detection of various drug interactions in dermatology in a tertiary care teaching hospital. Methods: An observational, prospective study was conducted for a period of six months (July 2017 to December 2017) among 108 patients in dermatology department of Santhiram Medical College and General Hospital, Nandyal. Results: A total of 108 patients were included in the study. Among them, 63 (58.3%) were males and 45(41.7%) were females. Of total 108 prescriptions, sever drug-drug interactions were present in 42 (38.9 %) prescriptions. Whereas, moderate drug-drug interactions were found in 14 (13%) and 52 prescriptions doesn’t have drug-drug interactions respectively. The study found the associations of potential drug interactions with age, sex, number of drugs per prescription. There was a direct link between polypharmacy and occurrence of drug interactions. To lower the frequency of potential interactions it could be necessary to make a careful selection of therapeutic alternatives, and in cases without other options, patients should be continuously monitored to identify adverse events. Conclusion: we concluded that educational interventions can minimize the incidence of drug interactions.

scholarly journals Analysis of caesarean sections using Robson’s classification system in a tertiary care centre in Northern India: an emerging concept to audit the increasing caesarean section rate

2021 ◽  
Vol 10 (6) ◽  
pp. 2281
Author(s):  
Deepika Jamwal ◽  
Pallavi Sharma ◽  
Anil Mehta ◽  
Jiteshwar Singh Pannu
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Delivery ◽  
Tertiary Care ◽  
Group Classification ◽  
Health Concern ◽  
Medical College ◽  
Clinical Scenarios ◽  
Group 5 ◽  
Group 2

Background: There has been an increase in rate of caesarean section over last five decades. This is a matter of international public health concern as it increases the caesarean section related maternal morbidity. The aim of the present study was to evaluate that in a new medical college which clinical situation contributed and led to caesarean deliveries as per Robson’s classification system and to audit the increasing rate of caesarean section.Methods: This study was performed in Government Medical College Kathua in the Union territory of Jammu and Kashmir from November 2020 to April 2021. In the present study, all cases delivered by caesarean section during the period of six months were recorded and classified according to Robson's 10 group classification system.Results: Out of total 1366 women delivered, 630 underwent CS (46.12%). It was observed that majority of caesarean sections belonged to group 2 and group 5 of Robson criteria. Group 5 comprised of patients with one or more previous caesarean section with cephalic presentation according to Robson criteria and maximum number of caesarean sections done in the present study belonged to this group that is 40.3%. Group 2 that is nulliparous singleton cephalic >37 week induced labour or caesarean section before labour comprised 29.2%. Breech pregnancies (groups 6 and 7) had >90% caesarean rates.Conclusions: Women with a previous caesarean delivery represent an increasing proportion of caesarean deliveries. Use of the Robson criteria allows standardized comparisons of data and identifies clinical scenarios driving changes in caesarean rates. Hospitals and health organizations can use the Robson 10-Group Classification System to evaluate quality and processes associated with caesarean delivery.

scholarly journals Analysis of caesarean delivery using Robson ten group classification system at a tertiary care teaching institute in Kerala, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1990
Author(s):  
Heera Shenoy T. ◽  
Sheela T. Shenoy ◽  
Anaswara T. ◽  
Remash K.
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
College Hospital ◽  
Robson Classification ◽  
Group 5 ◽  
Group 2

Background: Globally, the caesarean delivery rate is rising continuously, making caesarean one of the most common surgical procedures. The Robson classification, appreciated by WHO in 2014 and FIGO in 2016 is widely accepted, risk-based, ten-group classification system (TGCS) developed specifically to assess caesarean section rates. The aim of this study was to know the rate of Caesarean section in present hospital, to analyse the Caesarean sections based on Robson’s classification and to determine the contribution and significance of each group on the overall number of Caesarean sections.Methods: All women, who gave birth by Caesarean deliveries done over a period of 1 year (January 2018-December 2018) in Travancore Medical College Hospital in South Kerala India.Results: Group 5 (previous LSCS, single, cephalic >37 weeks) made the greatest contribution to the Caesarean section rate (27.24%). The second highest contributor was Group 2 (Nulliparous, singleton, cephalic, >37 weeks induced labour or caesarean section before labour followed by Group 10 (all single cephalic <36 weeks including previous CS) 18.78%.Conclusions: Limiting the CS rate in low-risk pregnancies is key to lowering the trend of increased CS. If TGCS is used uniformly, CS rates can be compared over time and between units, both nationally and internationally.

scholarly journals Audit of caesarian deliveries in a tertiary care center, in rural Bangalore, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1408
Author(s):  
Rajiv K. Saxena ◽  
Anju Balan
Keyword(s):  
Caesarean Section ◽  
Teaching Hospital ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
External Cephalic Version ◽  
Tertiary Care Center ◽  
Tertiary Care Teaching Hospital ◽  
Breech Delivery ◽  
Care Teaching

Background: The Robson’s Ten-Group Classification System allows critical analysis of caesarean deliveries according to characteristics of pregnancy. The objective was to analyze caesarean section rates in a rural tertiary care teaching hospital in Bangalore, using Robson’s ten groups classification.Methods: This study was done in MVJ Medical College and Research Hospital, a rural tertiary care teaching hospital. All patients who underwent caesarean delivery, between November 2017 and October 2018, were included in the study. Women were classified in 10 groups according to Robson’s classification. For each group, authors calculated its relative contribution to the overall caesarean rate.Results: The overall caesarean section rate was 46.7%. The main contributors to this high caesarean rate were primiparous women in spontaneous labour (group 1) and women with previous caesarean section (group 5).  52.1% of CS were conducted on women who were unbooked or booked at a peripheral health facility and referred to present institution due to complications in labor. Strategies to lower CS rates would include encouraging women with previous CS, to undergo trial of labor to reduce CS rates for group 5C. Sensitization of staff in peripheral medical facilities for early referral of high-risk pregnancies to a tertiary care center for better control of medical complications like hypertensive disorders of diabetes mellitus. Other strategies include offering external cephalic version to eligible women with breech presentation and consider offering vaginal breech delivery to suitable women in groups 6 and 7.Conclusions: The Robson’s classification is easy to use. It is time to implement obstetric audit to lower the overall CS rates.

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