scholarly journals PROM and it’s maternal outcome: a retrospective study in a rural medical college of India

Author(s):  
Malay Sarkar ◽  
Tanushree Mondal ◽  
Manojit Sarkar

Background: Premature rupture of membrane is the unconstrained break of layer before the beginning of  labor and can happen any gestational age even at 42 weeks of growth. Around 2-30 % of all pregnancy will encounter PROM and prompts 33% of preterm birth. The analysis of PROM is to a great extent clinical and is normally proposed by a history of watery vaginal discharge and affirmed on sterile speculum assessment. This examination was led to decide the occurrence, to discover the age, equality dispersion, gestational age dissemination, presentation of PROM and plan the line of the management.Methods: The cases selected in this study were those who had spontaneous rupture of membrane after 28 weeks of gestation but before the onset of labor pain. The study period was of one year from 1st January 2019 to 31st December 2019. The study was conducted in the labor room complex of Coochbehar Govt. Medical College and Hospital, WB India. The patients were admitted in the labor room through emergency. All datas were collected from labor room log book.Results: Total no. of deliveries were 10900 and total no of PROM were 545.Incidence of PROM is 5% in the present study. Maximum no of cases were in the age group between 20-29yr (63%). PROM mainly occurs in primigravida (50.45%). And low rupture of membrane was 91.8%. Cephalic is the commonest presentation (85%) in PROM and the incidence of caesarean section is 24.95%.Conclusions: PROM is the obstetric emergency and once the PROM is diagnosed it is important to weigh the risk of PROM and prematurity and make the right choice of conservative management and active management. If there is chance of maternal morbidity pregnancy should be terminated considering the maternal wellbeing first and then that of the fetus.

2020 ◽  
Vol 32 (2) ◽  
pp. 94-98
Author(s):  
Arnab Mondal ◽  
Rupak Ranjan Roy ◽  
Asok Kumar Mondal

Background: Premature rupture of membranes (PROM) is a common obstetric complication. Knowledge of etiopathogenesis, diagnosis, complications & management of PROM has increased due to extensive research in the recent past. Yet, there is no unanimous opinion regarding optimum management of PROM. The aim of the study was to observe the patients during labor and compare the latent period, duration of first stage of labor, modes of deliveries and the use of oxytocin and its outcome in PROM cases with controls. Materials and methods: In this study, the definition of PROM used is – rupture of fetal membranes before the onset of true labor pain. The minimum gestational age was taken to be 28 weeks. Diagnosis of PROM was mainly clinical. A cohort study was conducted in the Dept. of Obs & Gynae of KPL Medical College & Hospital, Kolkata on 100 cases of PROM and 100 cases of comparison group, over a period of one year. Results: It was observed that onset of labor was more rapid with increasing gestational age, use of oxytocin for induction & augmentation of labor & operative deliveries were higher in PROM cases. Conclusion: Individualized management of PROM cases depending on the gestational age and risk of complications is the best way to achieve a good feto-maternal outcome. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 94-98


2013 ◽  
Vol 12 (3) ◽  
pp. 44-48
Author(s):  
Joyabrata Das ◽  
Subash Majumdar ◽  
Subrata Das ◽  
Saiem Nurul Anwar ◽  
Hossain Ahmed ◽  
...  

Background: The liver is the organ most subjected to the development of abscesses and made up 48 % of all visceral abscesses' and 7% of all intra abdominal abscesses. Liver abscess should be suspected when there is a combination of fever, leucocytosis, constitutional symptoms, and pain in the right upper quadrant, and tenderness over the liver or right lower rib cage. The liver is affected by a number of local and disseminated infections; their frequency and types vary considerably around the world. Parasitic disorders are more prevalent in developing countries. Methods: It was a cross-sectional descriptive study. The cases were taken from the admitted patients of Medicine unit of SMCH, Chittagong. The study was conducted over a period of one year with a sample size of 50 patients and sample was taken by purposive sampling. Results: Among 50 patients 40 (80%) were diagnosed as ALA and 10 (20%) were diagnosed as PLA. ALA cases are common in 21-30 years age group & PLA cases are more common in >50 years of age group. Majority of the cases were from rural area. Common clinical features were fever, abdominal pain, nausea and tender hepatomegaly. Diarrhea was present on admission in 7 (15.9%) patients of ALA. Anaemia was common in both but polymorphonuclear leucocytosis was moderate to severe in PLA. Microscopic examination of stool samples for E. Histolytica trophozoites was positive in 3 (7.5%) cases and cysts in 4(10%) cases. Nine patients had right sided pleural effusion. Conclusions: Clinical features are common in both ALA and PLA. Liver abscesses are more common in men and more prevalent in rural areas. ALA more commonly occurs in 21-30 years age group but can occur at any age. Pyogenic abscess is more common in older age group (>50 years) and E. Coli is the commonest organism. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 44-48


2017 ◽  
Vol 29 (2) ◽  
pp. 5-8
Author(s):  
Jahangir Alam Mazumder ◽  
Rafiqul Islam Sarker ◽  
AHM Delwar ◽  
Kamrunnahar

Ear foreign body is a common ENT emergency and a challenge also to otolaryngologist worldwide. Prompt and appropriate management of it can reduce the morbidity. An observational retrospective study of 148 cases of foreign body in the ear done in Comilla Medical College Hospital and two upazilla health complexes (Nangalkot and Chowddagram) of Bangladesh within the period of January 2014 to December 2014 to evaluate the nature, mode of presentation, technique of removal and outcome of it. Data were collected from hospital records including age, sex of patient and mode and time of presentation, nature of foreign body, management outcome and complication, and the result showed that children o funder 15 year age group were mostly affected (60%), among them highest incidence were in 5-10 year age group (25%) with male to female ratio 1:1.28. The most common foreign body was the seeds of various vegetables (25.67%) followed by plastic beads (18.24%) and cotton bud (15.54%), the right ear affected more (54%). Almost half of them (47.97%) presented with history of insertion of a foreign body and most of them (91.98%) were removed in OPD or emergency department under direct vision and remaining required general anesthesia. Despite a high proportion of cases managed in the office setting, complication rates were within acceptable level. It is inversely proportional to the skill of the personnel, number of attempts &availability of equipment. Key to successful outcome are prompt help by well-trained doctor and otolaryngological equipment set up.Medicine Today 2017 Vol.29(2): 5-8


Author(s):  
Akshy Kumar ◽  
Mukul Sharma

<p class="abstract"><strong>Background:</strong> Melasma is an acquired increased pigmentation of the skin, characterized by gray-brown symmetrical patches, mostly in the sun-exposed areas of the skin.</p><p class="abstract"><strong>Methods:</strong> The proposed study is an epidemiological cross sectional study which was carried out in the department of dermatology in a teaching institute from October 2007 to September 2008 at Pramukh Swami Medical College, Karamsad, Gujarat. A total of 60 patients were enrolled for the study over a period of one year.<strong></strong></p><p class="abstract"><strong>Results:</strong> The main age group affected was 30-39 years i.e. 48.33% patients. 50 patients were females.18 patients had a positive family history of melasma. 12 patients had a positive history of using OC Pills. Malar region was the commonest affected area found in 52 patients followed by Centro-facial in 31 and least involvement was seen in forehead region in 24 patients. 20 patients reported association of occurrence of the lesions with pregnancy, 09 patients reported sunlight to be the offending agent.</p><p class="abstract"><strong>Conclusions:</strong> Females were affected more commonly during their late third decade of life. Although we did not find the exact cause of melasma, we noticed that sun-exposure, pregnancy, and taking of oral contraceptive pills could precipitate or exacerbate the melasma.</p>


2021 ◽  
Vol 13 (4) ◽  
pp. 587-593
Author(s):  
Ramiro A. Pérez de la Torre ◽  
Job J. Rodríguez Hernández ◽  
Ali Al-Ramadan ◽  
Abeer Gharaibeh

Background: Phantom limb syndrome is defined as the perception of intense pain or other sensations that are secondary to a neural lesion in a limb that does not exist. It can be treated using pharmacological and surgical interventions. Most medications are prescribed to improve patients’ lives; however, the response rate is low. In this case report, we present a case of phantom limb syndrome in a 42-year-old female with a history of transradial amputation of the left thoracic limb due to an accidental compression one year before. The patient underwent placement of a deep brain stimulator at the ventral posteromedial nucleus (VPM) on the right side and removal secondary to loss of battery. The patient continued to have a burning pain throughout the limb with a sensation of still having the limb, which was subsequently diagnosed as phantom limb syndrome. After a thorough discussion with the patient, a right stereotactic centro-median thalamotomy was offered. An immediate response was reported with a reduction in pain severity on the visual analogue scale (VAS) from a value of 9–10 preoperative to a value of 2 postoperative, with no postoperative complications. Although phantom limb pain is one of the most difficult to treat conditions, centro-median thalamotomy may provide an effective stereotactic treatment procedure with adequate outcomes.


2014 ◽  
Vol 3 (2) ◽  
pp. 54-56
Author(s):  
Mahendra R Pandey ◽  
Neeva Ojha

Twenty-one year unmarried regularly menstruating lady without history of amenorrhea presented with acute abdomen in TU Teaching Hospital –Emergency Department. On evaluation urine pregnancy test was positive. Urgent ultrasound revealed multiloculated cystic lesion measuring 8.5 x 8 x 6.7 cms in the right adnexa anterolateral to the uterus with no intrauterine gestational sac. She underwent emergency laparotomy with right salpingo-oophorectomy. On laparotomy there was twisted and ruptured right ovarian cyst with unruptured ampullary pregnancy on the same side. There was coexistence of these two conditions which presented as acute abdomen. DOI: http://dx.doi.org/10.3126/njog.v3i2.10834 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 54-56


2021 ◽  
Vol 8 (3) ◽  
pp. 501
Author(s):  
Gouda A. P. Kartikeswar ◽  
Dhyey I. Pandya ◽  
Siddharth Madabhushi ◽  
Vivek M. Joshi ◽  
Sandeep Kadam

Background: Preterm premature rupture of membranes (PPROM) predisposes the mother for chorioamnionitis, endometritis, bacteremia and neonate to preterm delivery related complication. There is often dilemma regarding the management of PPROM in mothers with gestational age (GA) <34 weeks.Methods: A retrospective cohort study conducted in a tertiary care hospital over two year period. Neonates delivered before 34 weeks were enrolled and categorized into active management (AM) and expectant management (EM) group. Associated risk factors, duration of PPROM and latency period, Neonatal outcomes like sepsis, morbidity, duration of respiratory support, duration of NICU stay compared between groups.Results: Out of total 197 cases, AM group had 91 babies. Active management resulted in earlier delivery [mean GA (SD): 30.88(1.8) VS 31(2.1) weeks], higher number of caesarian section (76.9% versus 53.8%), lesser birth weight {1233.6 (±282.9) versus 1453.39 (±380.6) gm} and more ELBW babies (23.1% versus 7.5%). EM resulted in significantly higher antenatal steroid cover (73.6% in AM versus 89.6% in EM) and lesser need of surfactant for RDS [42.9% versus 28.3%]. Significant difference was found for NICU stay days {mean (SD): 25.46 (16.8) versus 20.94 (17.5)}. No difference found between respiratory support days [median (IQR) 2 (0, 6) versus 2 (0, 7)]. No significant differences found in incidence of maternal chorioamnionitis, NEC, sepsis, BPD and ROP. Early delivery resulted in higher mortality though that was statistically not significant.Conclusions: Gestational age at delivery is more important predictor of neonatal outcome then PPROM in early preterm. 


2020 ◽  
Vol 15 (1) ◽  
pp. 110-113
Author(s):  
Md Abdur Razzak ◽  
Ghulam Kawnayn ◽  
Fateha Naznin ◽  
Quazi Audry Arafat Rahman

Moyamoya disease is a disease in which certain arteries in the brain are constricted. Blood flow is blocked by the constriction, and also by blood clots (thrombosis). A collateral circulation develops around the blocked vessels to compensate for the blockage, but the collateral vessels are small, weak, and prone to bleeding, aneurysm and thrombosis which may result in TIA, recurrent ischemic or hemorrhagic stroke or seizure. The disease may manifest in pediatric age or young adults. In May 2019 we have diagnosed a young lady with Moyamoya disease who presented with right sided hemiplegia, motor aphasia and dysphagia. She was labeled as hypertensive 6 months prior to this event and used to take anti-hypertensive irregularly and gave past history of occasional headache. Her CT scan and MRI of brain revealed left sided ischemic infarct involving frontotemporoparietal region and cerebral angiogram revealed narrowing of left MCA and non-visualization of distal part. There is extensive fine collaterals (Moyamoya vessels) giving the appearance of puffed smoke. The right ACA and MCA were also narrowed with appearance of early collateral vessels. She was treated with aspirin, PPI, NG feeding, antihypertensive medication, physiotherapy, rehabilitation therapy and other supportive care. His condition gradually improved and discharged on 2.7.19. He was referred to Department of Neurosurgery for cerebral revascularization by STA-MCA (superficial temporal and middle cerebral arteries) bypass surgery after stabilization and MR perfusion study. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 110-113


2021 ◽  
Vol p5 (5) ◽  
pp. 3050-3054
Author(s):  
Shubha C ◽  
Amanda Kittie Kynshikhar ◽  
Pooja B A ◽  
Sangamitra Pattnaik ◽  
Abhishek Biswas

A Hindu female patient of age 30 yrs. with a history of dry scaly white patches over the skin since childhood with prevailing signs of swelling wounds over the patches on the right foot and left palm for six months, diagnosed as a case of Psoriasis came for treatment at Sushrutha Ayurvedic Medical College & Hospital, Bangalore. Considering the signs and symptoms patient was treated in the line of Ekakustha. Classical Virechana Karma followed by Shamana Aushadhi and Madhutailika Basti was administered. Significant relief was found in the signs and symp- toms with no recurrence after the treatment. Keywords: Ekakushta, Psoriasis, Classical Virechana, Madhutailika Basti, Shamana Aushadhi.


2013 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ajay Risal ◽  
Pushpa Prasad Sharma ◽  
Rajkumar Karki

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630


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