scholarly journals Pregnancy outcome study between Pradhan mantri surakshit matriva abhiyan service utilization group and pradhan mantri surakshit matriva abhiyan service non-utilization group: a comparative study

Author(s):  
Purnima Mandal ◽  
Jaydeb Mandal

Background: Safe pregnancy has become a social movement in our country. Almost 15 % of all pregnant women can develop potentially life-threatening complications. As a result, identification of high-risk pregnancies at earliest stage will be useful in directing appropriate intervention. Hence this study was done to evaluate the betterment of pregnancy outcome of the women who had taken the adequate service of Pradhan Mantri Surakshit Matriva Abhijyan service (PMSMA) than who had not.Method: A longitudinal study was conducted at Malda medical college during January 2019 to June 2019. 385 women selected who had taken at least three antenatal checkups (from record analysis) at PMSMA designated clinic and another 385 women selected who had not taken PMSMA services. Women of both groups were followed up their delivery events and puerperal days till discharge from hospital. Pregnancy outcomes were compared and statistical analysis of both groups were done by SSPS software. Results:  A significant outcome difference of PMSMA service utilized and non-utilized groups in respect to fetal and maternal parameters including moderate to severe anemia, (12.98% vs 26.49%), intra uterine growth retardation (IUGR, 20.0% vs 29.87%), hypertensive disorders in pregnancy (HDP, 8.31% vs 13.50%), low-birth-weight (21.30% vs 31.16%) and stillborn (1.29% vs 2.89%) were observed.Conclusions: This study showed positive pregnancy outcome of PMSMA utilized group than non-utilized group. Improving the availability and accessibility of quality antenatal and delivery care through PMSMA services in all our institutions, will improve pregnancy outcome.

1970 ◽  
Vol 17 (2) ◽  
pp. 99-103
Author(s):  
MI Bari ◽  
MQK Talukdar ◽  
FH Nazir ◽  
AB Siddiqui ◽  
MH Haidary

Fifty children with Kala-azar {27 male (54%) and 23 female (46%)} aged between 2-12 yrs, were studied retrospectively in the pediatric unit of Rajshahi Medical College Hospital to find out the optimal treatment of Kala-azar in children. Sodium stibogluconate was given intravenously at a dose of 10 mg/kbw/day for 20 days in one group (Group-A), 15 mg/kbw/day for 20 days in another group (Group-B), 10 mg/kbw/day B.D. for 20 days in another group (Group-C), and 20 mg/kg of body wt/day for 40 days is last group (Group-D). The apparent cure rates of all regimens were 100%. Side effects of sodium stibogluconate were mild, however, myocarditis developed on 37th day of treatment in one patient which reversed to normal after discontinuation of the drug. 27 patients (54%) could be followed up to six months after discharge from hospital. Two patients in group-A relapsed and none relapsed from group B, C or D. Follow-up of patients in group B, C and D showed improvement in general condition, increase in body weight, Hb% and regression of the size of the liver and spleen and ultimate rate of cure in B, C, D regimens were 100%. But ultimate cure rate in-group A was 71.4% and the significance of difference between A and other regimens (P<0.10) were statistically significant. Sodium stibogluconate 15mg/kg body weight once daily for 20 days (Group-B) had the best of cure rate with low toxicity and may be recommended for routine treatment of childhood Kala-azar in this country.   doi: 10.3329/taj.v17i2.3455   TAJ 2004; 17(2): 99-103


Author(s):  
K. Hima Bindu ◽  
E. Rama Devi

Background: I Pregnancy induced hypertension causes intra uterine growth retardation, pre-mature delivery, intra uterine death of fetus, abruption placentae. It also causes increased morbidity and mortality among women. The objective of the present study is to observe the effect of pregnancy induced hypertension on pregnancy outcome.Methods: A hospital based cross sectional study was carried out to study the effect of pregnancy induced hypertension on pregnancy outcome for a period of two years from April 2004 to March 2006 at Gandhi Medical College, Hyderabad. Results: The mean maternal age in group I was 22.9 years comparable to group II. The incidence of PIH was 10.7% among primipara compared to 9.1% among multi parous women. Mean gestational age at entry to the present study was comparable among both the groups. Mean gestational age at delivery was higher in normotensive women compared to women with PIH. The incidence of low birth weight was 70% among PIH group compared to only 16.7% in normotensive group and this difference was found to be statistically significant. The incidence of intra-uterine growth retardation (IUGR) was 70% among PIH group compared to only 16.7% in normotensive group and this difference was found to be statistically significant. The incidence of pre-term delivery was 70% among PIH group compared to only 16.7% in normotensive group and this difference was found to be statistically significant.Conclusions: T Pregnancy induced hypertension was positively associated with adverse outcome. Early diagnosis and proper management can help to overcome and tackle most of the adverse outcomes.  


Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.


2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110


1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77


KYAMC Journal ◽  
2018 ◽  
Vol 9 (3) ◽  
pp. 133-135
Author(s):  
Joya Debnath ◽  
Arpan Kumar Basak ◽  
Md Zubaidur Rahman ◽  
Anujit Saha

Background : Self poisoning with organophosphate pesticides is a major health problem in world wide. Organophosphorus compound poisoning is a very common toxicological emergency encountered at Mirzapur in Tangail. It is particularly common among the rural agricultural worker's which comprise a substantial group of the population of this region.Objective: The objective of this study was to find out the incidence, frequency, pattern of poisoning, outcome and aetiological aspect of Organo phosphorus poisoning patient admitted in Kumudini Women's Medical college Hospital.Methods: A total 366 cases of OPC poisoning were analysed during 1 year from January 2015 to December 2015. The emphasis was given on age, sex, socio-economic status, occupation, motive of poisoning, types of compound consumed its quality, place, distance from referral place and the ultimate outcome.Results: Young population of rural background, particularly agricultural workers were the commonest patients (51.91%). The most common motive of poisoning was with a suicidal intent, both in males (27.59%) and females (66.39%). Financial crisis was one of the most common reasons analysed as the motive behind the poisoning (54.20%). Three hundred forty four Patients recovered and 22 were expired. The major cause of death in these cases was respiratory failure followed by multi-organ failure.Conclusion : Strict of the pesticide act and involving a new policy by the government to educate the public and youth in large about the dangerous, life threatening effects of Organophosphorus compound could help amelerioating the harmful effects of such poisoning.KYAMC Journal Vol. 9, No.-3, October 2018, Page 133-135


Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Sanjay Bhalchandra Londhe ◽  
Ravi Vinod Shah ◽  
Amit Pankaj Doshi ◽  
Shubhankar Sanjay Londhe ◽  
Kavita Subhedar ◽  
...  

Abstract The aim of this retrospective cohort study was to compare home physiotherapy with or without supervision of physiotherapist for assessing manipulation under anaesthesia after total knee arthroplasty. Methods A total of 900 patients (including 810 females and 90 males) who had undergone total knee arthroplasty were divided into group A (n = 300) and group B (n = 600). Patients in group A had home physiotherapy on their own after discharge from hospital. The physiotherapist did not visit them at home. Patients in group B received home physiotherapy under supervision of physiotherapist for 6 weeks after discharge from hospital. Patients’ age, range of motion of the knee, and forgotten joint score-12 were assessed. A p < 0.05 was considered statistically significant. Results In group A, the mean age was 69.1 ± 14.3 years (range: 58 to 82 years); in group B, the mean age was 66.5 ± 15.7 years (range: 56 to 83 years) (p > 0.05). Preoperatively, the mean range of motion of the knee in group A and B was 95.8° ± 18.1° and 95.4° ± 17.8°, respectively (p > 0.05). The mean forgotten joint score-12 of group A and B were 11.90 ± 11.3 and 11.72 ± 12.1 (p > 0.05), respectively. Six weeks after total knee arthroplasty, the mean ROM of the knee in group A and B was 109.7° ± 22.3° and 121° ± 21.5°, respectively (p < 0.05). The mean postoperative forgotten joint score-12 of the group A and B was 24.5 ± 16.4 and 25.6 ± 17.4, respectively (p > 0.05). The rate of manipulation under anaesthesia was 3% in group A and 0.2% in group B (p < 0.05). Conclusion After total knee arthroplasty, frequent physiotherapist’s instruction helps the patients improve knee exercises and therefore decrease the risk of revision surgery. The home physiotherapy under supervision of physiotherapist lowers the rate of manipulation under anaesthesia. Level of evidence Therapeutic study, Level IIa.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Menezes ◽  
D Lewer ◽  
A Yavlinsky ◽  
M Tinelli ◽  
R Aldridge

Abstract Introduction The number of people experiencing homelessness in England has increased since 2010 and a recent systematic review and meta-analysis demonstrated high levels of mortality in this group across high-income countries. In this study we examine the death rates in people experiencing homelessness after discharge from hospital. Methods This is a study of linked hospital admission records and mortality data for two groups. First, a “Homeless group”: people seen by 17 specialist homeless discharge schemes between 1 November 2013 and 30 November 2016. Second, an “IMD5 group”: A matched group of patients who live in deprived areas and have the same age and sex, and were discharged from the same hospital in the same year as the homeless patient. Our analysis entailed calculating mortality rates across each group and by the number of comorbidities. Results The mortality rate for the IMD5 group was 1,935 deaths per 100,000 person years, compared with 5,691 for the homeless group, giving a rate ratio of 2.9 (95% CI 2.5-3.5). The mortality risk increased with the number of comorbidities. Individuals in the IMD5 group with zero comorbidities had a death rate of 831 per 100,000 person-years, compared with the homeless group for which the corresponding figure was 2,598 and or those with 4+ comorbidities were 7,324 (IMD5) and 12,714 (homeless). This suggests a 'super-additive' interaction in which the effect of morbidity on mortality risk after discharge is greater for homeless patients. Survival at 5 years for the homelessness group was for men 80% (95% CI 77-85) and women 85 (95% CI 81-87). Conclusions This study shows that the well-established inequity in mortality for people experiencing homelessness exists after discharge from hospital and is greatest for the most unwell patients. Our results suggest a need for greater emphasis on prevention of homelessness, early healthcare interventions and improved hospital discharge arrangements for this population. Key messages The well-established inequity in mortality for people experiencing homelessness exists after discharge from hospital and is greatest for the most unwell patients. Our results suggest a need for greater emphasis on prevention of homelessness, early healthcare interventions and improved hospital discharge arrangements for this population.


2015 ◽  
Vol 5 (2) ◽  
pp. 329-331 ◽  
Author(s):  
Laila Helaly ◽  
Md Zakir Hossain Sarker ◽  
MA Mannan ◽  
Md Tafazzal Hossain ◽  
Shafi Ahmed ◽  
...  

Objective : The present prospective randomized clinical trial was carried out to assess whether combined cefepime and amikacin as empirical antibiotic therapy was more effective than combined ceftriaxone and gentamicin in the treatment of febrile neutropenic children with malignant diseases.Material & Methods : The study was conducted in the Pediatric Hematology and Oncology unit of BSMMU over a period of 2 years. (From January 2006 to December 2007) Hospitalised pediatric cancer patients who developed febrile neutropenia following chemotherapy or radiotherapy were the study population. A total 64 cases were consecutively included in the study and were randomly assigned to either cefepime & amikacin group (Group- A) or ceftriaxone & gentamicin group (Group-B). The Group-A received cefepime 1500 mg/m2/dose infused over 15 minutes in two divided doses intravenously(IV) while amikacin was administered as thrice daily dose of 200 mg/m2/dose. Patients of Group-B received ceftriaxone 1500 mg/m2/dose in two divided doses and gentamicin 60 mg/m2/dose thrice daily IV. The therapy was continued until absolute neutrophil counts reached >1000 neutrophils/mm3. The treatment outcome was considered successful if fever resolves within 4 days and does not recur within 7 days of completion of therapy. Of the 64 patients, 13 cases were excluded from the final analysis.Results : Bacteria were isolated from culture in only 16.7% of cases Group-A and 9.5% of group-B. Patients E. coli was the most common isolate found in blood specimen (37%). Following intervention, 90% of cefepime & amikacin group and 85.6% of ceftriaxone & gentamicin group improved absolute neutrophil count to >1000/mm3 of blood. Persistence of fever after start of study drug and duration of antibiotic therapy were significantly less in the former group than those in later group (p = 0.049 and p = 0.004 respectively). Only 1 patient of group B had recurrence of infection within 7 days of treatment completion. The mean duration of hospital stay was less in the former group (7.97 ± 2.61 days) than that in the latter group (11.00 ± 3.42 days) (p = 0.06). Evaluation of final outcome shows that majority (86.6%) of cefepime & amikacin group had successful outcome, while majority of ceftriaxone & gentamicin group (81%) failed to resolve infection with continuation of fever for > 4 days.Conclusion : The study concluded that combined cefepime and amikacin is a better option for empirical treatment of fever and neutropenia in children with malignancies than combined ceftriaxone and gentamicin (p<0.001).Northern International Medical College Journal Vol.5(2) 2014: 329-331


KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24


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