scholarly journals Invasive genetic testing in pregnancy: experience from a tertiary care center

2021 ◽  
Vol 10 (5) ◽  
pp. 1991
Author(s):  
Gunjan Rai ◽  
Sudhirman Singh ◽  
Bikram Bhardwaj
Keyword(s):  
High Risk ◽  
Single Gene ◽  
Tertiary Care ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Androgen Insensitivity Syndrome ◽  
Care Hospital ◽  
Number Of Patients ◽  
Thalassemia Minor ◽  
In Pregnancy

Background: Evaluation of outcome of pregnancies with high risk first trimester screening or abnormal ultrasonographic findings and complications of amniocentesis in second trimester and chorionic villous sampling in first trimester in a tertiary care hospital in India.Methods: This is a retrospective study in a tertiary care hospital from 2015 to 2017. All antenatal patients underwent combined nuchal translucency scan and dual screen ratio and who detected to have high risk for trisomy, they underwent amniocentesis/CVS. These procedures were done at minor OT in our hospital, taking aseptic precaution and under ultrasound guidance. First trimester combined screening included a detail nuchal translucency scan as per the international society of ultrasound in obstetrics and gynecology (ISUOG) guidelines and also biochemical screening done with serum beta human chorionic gonadotrophin (HCG) and pregnancy-associated plasma protein A (PAPP-A) in same genetic lab. Combined risk scoring done as high risk or low risk. Low risk patients without any genetic abnormality in previous obstetric history were followed as normal pregnancy. Results, complications and outcome of invasive genetic testing in pregnancy was observed. At our center CVS was done mostly for single gene disorder.Results: Out of 179 patients who underwent amniocentesis, total abnormal chromosomal were 14 (7.82%). The most common abnormality was trisomy 21 (4.46%). The other abnormalities were trisomy 18 (1.67%), trisomy 13 (1.11%) and triploidy XXY (0.55%). CVS was done for Nieman Pick disease, androgen insensitivity syndrome, both parents thalassemia minor and ultrasound abnormality detected early in pregnancy. For single gene disorder mutation identified in index case or in parents and same mutation looked in to fetus by chorionic villus sampling (CVS). For Nieman Pick disease, androgen insensitivity syndrome and both parent thalassemia minor, fetus detected to have heterozygous for same and nonpathogenic. Two patients underwent CVS for ultrasound abnormality out of which one detected to have trisomy 18 and other had loss of 2.1 Mb on Ch 22 in 22q11.21 region.Conclusions: Combined first trimester screening with nuchal translucency scan and dual screen ratio is an efficient method of screening with high sensitivity and low false positive rates. In our study prevalence of trisomy is slightly greater than other studies because number of patients were less and if we increase the number of patients probably we will have a prevalence data of trisomy similar to other studies which has been done for aneuploidy in fetus. 

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Postpartum Hemorrhage in Pregnancy beyond 40 Weeks of Gestation in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Rashmi Bastakoti Gaire ◽  
Suman Raj Tamrakar ◽  
Anjana Singh Dongol
Keyword(s):  
High Risk ◽  
Confidence Interval ◽  
Postpartum Hemorrhage ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
In Pregnancy

Introduction: Postpartum hemorrhage is defined as a blood loss of 500ml or more within 24 hours after birth. It is the leading cause of maternal mortality in low-income countries and the primary cause of nearly one-quarter of all maternal deaths globally. It occurs in up to 18% of total births. Post-dated pregnancy is a high-risk pregnancy with increased maternal morbidity. This study aims to determine the prevalence of postpartum hemorrhage in pregnancy beyond 40 weeks of gestation in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among pregnant women beyond 40 weeks in Dhulikhel hospital from October 2016 to March 2017. The study was conducted after ethical clearance from the hospital research committee (reference number#128/16). The sample size was calculated and convenient sampling was done. Statistical Package for the Social Sciences is used for analysis. Point estimate at 95% confidence interval was calculated along with frequency and percentage for binary data. Results: Out of 465 ladies enrolled in this study postpartum hemorrhage was seen in 6 (1.29%) (95% Confidence Interval = 0.267-2.31), and the mean age was 24.25+4.8. About 346 (74.4%) had a normal delivery, 104 (22.36%) had cesarean section and 15 (3.22%) had instrumental delivery. Conclusions: Postpartum haemorrhage prevalence is low among the pregnant women beyond 40 weeks compared to the standard study. Postpartum hemorrhage is the common leading cause of maternal mortality. So high-risk cases should be identified and active management should be done to reduce morbidity and mortality.

scholarly journals Risk assesment and management of exposure of health care workers to COVID-19 in a tertiary care hospital of South Gujarat

2021 ◽  
Vol 8 (2) ◽  
pp. 750
Author(s):  
Krishnakant N. Bhatt ◽  
Amit Gamit ◽  
Ashish Patel ◽  
Kalpesh Gohel ◽  
Shiv Pujari ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Young Male ◽  
Care Hospital ◽  
Age Group ◽  
Rt Pcr ◽  
Care Workers ◽  
Number Of Patients ◽  
Risk Categorization

Background: The COVID-19 outbreak affected 215 countries worldwide and was declared global COVID-19 pandemic on 11th March 2020 by WHO. Healthcare workers (HCWs) in India are faced with an incredibly high number of patients per worker and because of high infectivity of COVID-19, having higher chances of getting COVID-19 infection. The objective of the study was the risk categorization of HCWs and provide recommendation for HCWs exposed to COVID-19 based on risk categorization.Methods: After obtaining informed and valid consent from HCWs based on standard WHO questionnaire HCW, who were exposed to COVID-19 were identified and categorised in to high risk and low risk health worker. Those who were at high risk of getting COVID-19 were advised quarantine for 14 days and rt pcr for Covid-19.Results: Out of 200 participants, 51% were male and 49% were female with the majority of them being in the age group of 18-28 (40%). Out of 200, 190 (95%) were exposed to COVID-19. Majority of HCWs who were having high risk of getting COVID-19 infection were young between age group of 18-28 (66,39.7%, p :0.091), male (91,59.6%, p<0.001), doctors (119, 80.9%, p<0.001).Conclusions: Young male doctors were more prone to get COVID-19 infection. It is important to protect HCWs from getting COVID-19 infections by taking various fundamental preventive measures like wearing proper PPE kits and adherence to strict hand hygiene.

scholarly journals Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Severe Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Antibody Therapy ◽  
Additional Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Age Group ◽  
Number Of Patients ◽  
The Mean ◽  
Collection Form ◽  
Time Of Admission ◽  
Second Wave

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

Abstract 14747: Dwindling Trends of Cardiology Admissions Amidst Covid-19 Pandemic in a Tertiary Care Center of Pakistan

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jamshed Ali ◽  
Osman Faheem ◽  
Pirbhat Shams ◽  
ghufran adnan ◽  
Maria Khan
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Electronic Record ◽  
Medical Attention ◽  
Care Hospital ◽  
Record System ◽  
Admission Rates ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
The Impact

Introduction: Social containment measures have been adopted globally to control COVID-19 outbreak. Reduction in hospital visits and inpatient admission rates have become cause for concern. Through this study we aimed to analyze the impact of SARS-CoV-2 virus Outbreak on cardiology inpatient admissions at a tertiary care hospital in Pakistan. Hypothesis: COVID-19 pandemic has resulted in significant decline in cardiology admissions. Methods: We conducted a retrospective study at our center. Admission log was accessed via electronic record system. Comparison was made for same months of 2019 and 2020 with regard to cardiology inpatient admissions. Results: A total of 239 patients were admitted to cardiology services in 2019 period and 106 in 2020 period with resultant reduction of 55.6%. Number of patients admitted to the coronary care unit were 179 and 78 respectively where as the numbers declined to 28 from 60 for cardiac step down. Reduction for admission numbered to 52.4% for males and 38.89% for females. 9.3% patients left against medical advice in 2019 and 3.4% in 2020. Conclusions: Our study concludes that numbers of cardiology admissions have dwindled. Possible explanation for this can be implementation of social containment and fear of acquiring infection. This has raised a question of whether a significant number of cardiovascular morbidity and mortality has occurred without seeking medical attention and has went unrecorded during the pandemic. This calls for stringent diagnostic measures in future to diagnose previously unrecorded burden.

ASSESSMENT OF LIVER FIBROSIS IN ALCOHOLIC PATIENTS BY USING FIBROSCAN IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 43-47
Author(s):  
Veenit Kumar Prasad ◽  
Bapilal Bala ◽  
Biswadev Basumazumder ◽  
Achintya Narayan Ray
Keyword(s):  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Transient Elastography ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
Disease Patient ◽  
Liver Stiffness ◽  
Care Hospital ◽  
Non Invasive ◽  
Number Of Patients

INTRODUCTION: Alcoholic liver disease is one of the major causes of premature deaths worldwide. Alcohol induced liver injury is the most prevalent cause of liver disease and effects 10% to 20% of population worldwide. Alcoholic liver disease comprises a wide spectrum of pathological changes ranging from steatosis, alcoholicsteato-hepatitis, Cirrhosis and nally hepatocellular carcinoma. Our aims in this study are to detect this change by non invasive method by liver broscan and its clinical implications. MATERIALS AND METHODS: Total 200 patients were taken for observational study, conducted at Coochbehar Government Medical college and hospital both outpatient department and indoor patients from May 2019 to January 2020. Liver stiffness was assessed by ultrasound based method of transient elastography using Fibroscan machine. Gradation of liver stiffness was expressed in kilopascals (KPa). RESULTS: Maximum number of patients of alcoholic liver disease were between 40 - 49 years of age (42.5%). Male patients is 87.5% and female patients 12.5%. distribution of Rural population is 36 % and Urban population is 64%. Majority of population85 patients (42.5%) had fatty liver and 40 patients (20%) have hepatomegaly, 41 patients (20.5%) had Coarse echotexture of liver parenchyma and 54 patients (27%) had Splenomegaly, 62 patients (31%) had Nodular liver and 62 patients. It is observed that 11 patients (5.5%) had Fibroscan score ≤7.5 and 47 patients (23.5%) had broscan score 7.6 -9.9 and 40 patients (20%) had broscan score 10-12.4, 36 patients (18 %) had broscan score 12.5 – 14.6 and 66 patients (33%) have broscan score ≥ 14.7. CONCLUSIONS: Transient Elastography (TE) is a newer non invasive assessment technique to detect the progression of brosis or brosis in alcoholic liver disease patient. Major advantage is it is noninvasive (costeffective) so that we can early detect progression of this cirrhosis and can give efforts to halt the disease progression.

scholarly journals PITYRIASIS ROSEA MIMICKING POLYMORPHIC ERUPTIONS OF PREGNANCY

2017 ◽  
Vol 10 (10) ◽  
pp. 21
Author(s):  
Balaji Ommurugan ◽  
Amita Priya ◽  
Swaminathan Tambaram Natesh
Keyword(s):  
Pregnancy Outcomes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Unknown Etiology ◽  
Care Hospital ◽  
Pityriasis Rosea ◽  
Human Herpes Virus

ABSTRACTPityriasis Rosea is a self-limiting skin disorder of unknown etiology affecting women more than men. It is very rare in pregnancy and evidence shows conflicting reports on pregnancy outcomes related to Pityriasis Rosea. But however recent evidence says, pregnancy outcomes are not altered, although clinicians must monitor the patient throughout the gestation for adverse outcomes. Hence, we report a case of Pityriasis Rosea infection in a primigravida, in the first trimester and the follow up done in a tertiary care hospital in Southern India.KEYWORDSRASH, FIRST TRIMESTER, ANOMALY SCAN, HUMAN HERPES VIRUS

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