scholarly journals Changing trends in the incidence of caesarean section after a district hospital became medical college teaching hospital at Karwar, a coastal city in Karnataka-an eleven years retrospective audit

Author(s):  
Somashekharappa B. Kadur ◽  
Annappa B. Shetty

Background: Caesarean section (C-section) delivery has well established risks and adverse consequences. Every health care sector should look into the standards of maternal services it is providing. This audit look into the standards we have been providing at KRIMS Karwar with a comparison to national standards.Methods: This is a retrospective audit conducted by obstetrics and anaesthesia departments at KRIMS Karwar, Karnataka. Objectives were to look into incidence of C-sections, kind of anaesthesia used and maternal mortality. In addition, to look into any change in the obstetric care/outcome after Karwar district general hospital upgraded to a medical college teaching hospital. WHO guidelines for obstetrics care were set as standards. Retrospective data for the period between January 2007 and December 2018 has been collected and analysed.Results: Total number of pregnant women admitted for labour was 13431 with an average of 1221 per year. Proportion of caesarean delivery per hundred labouring women was 16.8 % in 2007 with significant increase to reach 51% in 2012. This has decreased in subsequent years to reach 23.5 in 2018. 99.9% of the C-sections have been done under spinal anaesthesia. There was one death of the mother subjected for C-sections in 2009.Conclusions: Incidence of C-sections was alarmingly high. Implementation of the uniform protocol has significantly reduced the C-sections rate. This reduction could be attributed to the upgrading the Karwar district hospital to a medical college teaching hospital. Protocol based practice will be continued and measures to improve overall maternity services will be implemented as per the WHO guidelines.

2020 ◽  
Vol 6 (1) ◽  
pp. 39-49
Author(s):  
Indira Adhikari Poudel ◽  
B Bhattarai ◽  
P Dhakal

Correction: The page numbers were changed from 57-67 to 39-49 on 31/08/2020. Background: Cesarean section (CS) rate has increased rapidly over the past two decades in world. It is serious concern for public health experts globally. Various medical and non-medical factors, such as maternal socio-demographics, are found to be responsible for this upsurge. Like in other countries, the rate of caesarean sections has increased in Nepal as well. Therefore, there is a need to investigate the factors behind this increase. Objectives: To identify the factors associate for caesarean section among mothers attending at teaching hospital, Chitwan Methods: A cross sectional analytical study was conducted using total enumerative sampling technique in the maternity ward of Chitwan Medical College Teaching Hospital. Interview was done with closed ended Questionnaire for data collection, a total number of 139 mothers after 24 hours cesarean section (CS). Results: The study shows that, nearly three- quarters (71.2%) of CS were performed as an emergency. There are mainly fetal, maternal and placental indication for cesarean section. The most frequent indications were: previous cesarean section (22.3%), thick Meconium stained liquor (12.2%), fetal distress (10.6%) and oligohydramnios (7.2%).


2003 ◽  
Vol 41 (144) ◽  
pp. 496-498
Author(s):  
Rachana Saha ◽  
N Bastola

The spontaneous conception & delivery of triplets occurs in 1: 6889 births. Most ofthe literature recommends caesarean section for triplets for better perinatal outcomeof especially second and third baby, however, we describe vaginally delivered tripletswith good perinatal outcome.1. Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.Address for correspondence : Dr. Rachana Saha, LecturerDepartment of Obstetrics and GynaecologyKathmandu Medical College Teaching Hospital, SinamangalP. O: 5919, Kathmandu, NepalKey Words: Triplets, Mode of delivery, Neonatal outcome.


2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  


Author(s):  
Iqbal Ahmad ◽  
Ummer Farooq Raina ◽  
Muhammad Yousaf ◽  
Liaqat Jalal ◽  
Samia Saeed ◽  
...  

2021 ◽  
Vol 6 (1) ◽  
pp. 1285-1290
Author(s):  
Nilam Kumari Jha ◽  
Komal Kant Jha

Introduction: Anxiety and Depression is a common comorbidity in chronic obstructive pulmonary disease patients. Impaired lung function is a risk factor for depression In COPD patients, reduced recreational activities and social Isolation is a major risk factor resulting in anxiety and depression.  Objective: The objective of this study is to evaluate the prevalence of Anxiety and Depression among the COPD patients at Pulmonology unit of Nobel Medical College Teaching Hospital.  Methodology: A hospital based cross- sectional research design was used for the study. A total of 185 patients with previously diagnosed COPD. Data were collected by using a face to face interview technique in patients to evaluate anxiety and depression using Nepali version of Hospital Anxiety and Depression Scale questionnaire at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from May to August 2020. Data analysis were done by descriptive and inferential statistics.  Results: A total of 185 patients participated in the study, 157 patients (84.9%) had anxiety, 107 patients (57.8%) had depression and 102 patients (55.1%) had both anxiety and depression. There was statistically significant association of anxiety and depression in COPD patients with age, religion, occupation, smoking status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, type of family, domiciliary oxygen therapy.  Conclusion: The study concluded that anxiety and depression had been most prevalent in COPD patients. Therefore health personnel working in the Pulmonology unit should be aware the early assessment and treatment of anxiety and depression of chronic obstructive pulmonary diseases patients. 


Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
Smita Singh ◽  
Deependra Prasad Sarraf ◽  
Prabin Singh ◽  
Pragati Poudyel

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.


2016 ◽  
Vol 12 (2) ◽  
pp. 11-16
Author(s):  
Upendra Pandit

Background: Primary documentation of a patient is crucial for making effective healthcare decision and improvements in the quality of care. The objective of this study was to assess the quality of current documentation practice in tertiary care hospitals. Materials and methods: This was an assessment of medical documentation practice of one year from the period of January 2010 to December 2010 in Chitwan Medical College, Teaching Hospital. Total 184 patients' discharge files were enrolled and reviewed. Documentation was reviewed in its quality such as completeness, Coherent, consistency and Legibility.Results: In overall pooled analysis, High omission rate was observed in final diagnosis, results (cure, improved, referral and death), hospital stay, and final case summary. Although, satisfactory performance was observed in complete set of forms (72.2%); Patient consent for treatment &release authorization forms (78.2%) and treatment chart (60.8%), the overall pooled performance in ten components showed50% performance gap. Study demonstrated that documentation and its legibility, coherent and consistency in all departments needs substantial improvements in the institution.JNGMC Vol. 12 No. 2 December 2014, Page: 11-16


2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha

Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52


2017 ◽  
Vol 2 (1) ◽  
pp. 134-137 ◽  
Author(s):  
Binita Pradhan ◽  
SB Pradhan

IntroductionIn developing countries, urinary tract infections (UTIs) are one of the most commonly diagnosed diseases among the patient seeking medical service and being treated with empirical antibiotics which causes resistance.ObjectiveTo find out the prevalence of urinary tract infection and sensitivity pattern of antibiotics among bacterial pathogens isolated in patients attending Kathmandu Medical College Teaching Hospital, Duwakot.MethodologyAll the patients with the clinical suspicion of UTI were sent for urine culture. Prevalence of UTI and urinary pathogens isolated with antimicrobial profile was correlated.ResultA total number of 1735 clinically suspected as UTI cases were sent for urine culture sensitivity. Total culture positive were 239 (13.8%). The majority of isolates were from female patients comprising 180 (75%). The most common pathogenic microorganism isolated was E.coli (79.1%). Second most common organism was Klebsiella (11.7%) followed by Citrobacter (3.34%) and Proteus (2.92%). The isolated microorganism showed maximum number of sensitivity with the antibiotics Ofloxacin and Ciprofloxacin. The isolated microorganism demonstrated resistance with Nalidixic Acid and Co-Trimoxazole. ConclusionUrinary tract infection is a commonly encountered case in general practice. Females are commonly affected than men. The microbiological profile and the antibiotic sensitivity pattern while initiating empirical treatment must be taken into account while planning for the management. Regular supervision of the sensitivity pattern of pathogenic microorganism is mandatory for effective treatment.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 134-137


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