scholarly journals Obstetric hysterectomy: a surgical emergency 3 years review in a tertiary care centre

2021 ◽  
Author(s):  
Shanti Sah ◽  
Shipra Gupta
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Developed Countries ◽  
Morbidity And Mortality ◽  
Bladder Injury ◽  
P Value ◽  
Blood Product Transfusion ◽  
Peripartum Hysterectomy ◽  
Emergency Procedures ◽  
Duration Of Surgery

Background: Obstetric haemorrhage is a life threatening complication associated with increased maternal morbidity and mortality. Its incidence is 0.2-4 per 1000 deliveries in developed countries and much higher in developing countries. The main cause still remains rupture uterus, postpartum hemorrhage (PPH) and placenta accreta spectrum (PAS).Methods: A retrospective analysis of obstetric hysterectomies performed over a period of 3 years from July 2017 to June 2020 was done. Incidence, risk factors, indication, outcome and complications of obstetric hysterectomies were evaluated.Results: A total 72 cases of obstetric hysterectomy were performed over 3 years period. Out of 72 cases, 33%, 28% and 14% cases were of peripartum hysterectomy done due to rupture uterus, PAS and PPH respectively. There was an increase in the incidence of PAS compared to previous years. There was no observed difference among patients undergoing total or subtotal hysterectomies. No difference as regard to duration of surgery, pre-operative or post-operative hemoglobin, IV fluid and blood product transfusion was noted among elective and emergency procedures. Statistically significant blood loss was observed in emergency hysterectomy compared to elective hysterectomy with p value of 0.004. An average need of transfusions was double in case of peripartum hysterectomy done for PPH compared to rupture uterus or adherent placenta. Bladder injury, burst abdomen and resuturing were three important morbidities. Maternal mortality was 2.8% in our study population.Conclusions: Emergency obstetric hysterectomy still remains a live saving procedure in case of catastrophic intractable hemorrhage and rupture uterus. Proper antenatal supervision, identification of risk factors and timely referral can reduce the incidence of associated morbidity and mortality.

scholarly journals Study of renal profile in septicemic neonates

2018 ◽  
Vol 5 (2) ◽  
pp. 448
Author(s):  
Sharwari J. Bhutada ◽  
Chandrakant M. Bokade
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
P Value ◽  
Etiological Agents

Background: Neonatal sepsis can cause multiorgan involvement causing neonatal morbidity and mortality. The kidneys are an important organ affected in septicemic newborns. In this study we evaluated the renal functions and its association with various risk factors along with outcome in septicemic neonates.Methods: This study was a prospective observational study conducted in a tertiary care teaching hospital. The sample size was 276 cases of septicemic new-borns and study duration was 2 years. The profile of acute renal failure (ARF) and various risk factors were studied in a sample of 276 septicemic neonates. Detailed clinical examination and investigations were done to confirm the diagnosis of neonatal sepsis and the occurrence of ARF was studied among these septicemic newborns. Risk factors like birth weight, gestational age, shock, etiological agents, DIC were studied for the occurrence of ARF and mortality in ARF patients among septicemic neonates.Results: 30.07% of septicemic neonates developed ARF. DIC (p value=0.014), shock (p value=<0.0001), gestational age (p value=0.005), birth weight (p value=0.003), were found to be analytically significant for the occurrence of ARF. Birth weight (p value=0.006), age of onset of sepsis (p value=0.019), shock (p value =<0.0001), oliguria (p value =<0.0001), and DIC (p value=0.015) were significant predictors of mortality in ARF among septicemic neonates.Conclusions: Awareness and early identification of various risk factors and ARF in septicemic neonates can prevent morbidity and mortality among neonates. 

Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

2017 ◽  
Vol 13 (3) ◽  
pp. 314-317
Author(s):  
Manisha Chhetry ◽  
Shanti Subedi ◽  
Basudeb Banerjee
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Care Center ◽  
Tertiary Care ◽  
Site Infection ◽  
Emergency Procedures ◽  
Membrane Rupture ◽  
Duration Of Surgery ◽  
Elective Cesarean ◽  
Associated Risk Factors

Background & Objectives:Post cesarean surgical site infection (SSI) is one of the commonly encountered complications which considerably increase the burden to health care. It is caused due to the interplay of various patient related, procedure related and iatrogenic factors. This study aims at identifying common risk factors for post cesarean SSI at our centre.Materials & Methods:This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included and their risk factors were studied.Results:Emergency procedures (82.97%) were more likely to develop SSI as compared to elective cesarean (17%). Among the patient related risk factors most of them were nulliparous (48.9%), term gestation (42.6%), malnourished (53.1%) and had history of prolonged leaking (44.68%) The mean age was 24.04±4.6years.Most of the patients who developed SSI were operated for repeat cesarean and fetal indications. Most patients who had SSI had at three to five per vaginal examinations (2.72±2). 66% of patient who had SSI had duration of surgery more than one hour. 68% of the surgeries which developed SSI were done by residents as compared to 32% of those done by consultantsConclusion:The commonly associated risk factors linked with post cesarean SSI are maternal age, emergency procedures, prolonged membrane rupture, multiple vaginal examinations, malnutrition and the experience of surgeon. 

scholarly journals Prevalence of intestinal parasitic infections in cases of diarrhoea among school children attending a tertiary care hospital: a two year study

2018 ◽  
Vol 5 (3) ◽  
pp. 873
Author(s):  
Ravi Kumar Tenali ◽  
Naveen Kumar Badri ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
School Children ◽  
Tertiary Care ◽  
Developed Countries ◽  
Hand Washing ◽  
Parasitic Infections ◽  
P Value ◽  
Care Hospital ◽  
Intestinal Parasitic Infections

Background: Globally every year 1.7 billion cases of diarrhoea are registered as per the WHO report 2017. Intestinal parasitic infections [IPI] are one of the top ten major public health problems in developing countries with an estimated prevalence of 30-60% in developing countries compared to 3% in developed countries. School age children are the common vulnerable group with the highest prevalence and infection intensities. The objective of the present study is to study the prevalence of parasitic infections in school children as a causative factor for diarrhoea and associated risk factors involved with relation to their hygiene and socio demographic characters.Methods: A cross sectional study was conducted for a period of two years from January 2015 to December 2016 and stool specimens from the children aged 5-18 years suffering from diarrhoea were screened for parasitic infections following standard guidelines and as per the ethical committee guidelines. The socio demographic characters, risk factors and hygienic characters of the cases were noted from the parents or guardians or children in a separate predesigned questionnaire sheet. Data was analyzed using SPSS software version 13 and P value<0.05 was considered significant.Results: T The prevalence of parasitic infections in the Present study was 22.95% and males were more common. 8-11 years was the most common age group and mean age was 11.6±1.8 years. Statistically significant association was found with hand washing before meals, socio economic status, and method of hand washing after defecation. Entamoeba histolytica was the major parasitic pathogen followed by Ascaris lumbricoides. Other parasites were Giardia lamblia, Ancylostoma duodenale, Cryptosporidium, Isospora, Enterobius and Trichuris trichura.  Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

scholarly journals Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

2017 ◽  
Vol 5 (2) ◽  
pp. 520
Author(s):  
Devi Meenakshi K. ◽  
Arasar Seeralar A. T. ◽  
Srinivasan Padmanaban
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Logistic Regression Analysis ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
P Value ◽  
Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

scholarly journals Early versus delayed cholecystectomy in acute cholecystitis: a comparative study in a tertiary care hospital

2020 ◽  
Vol 7 (8) ◽  
pp. 2656
Author(s):  
Jamal Uddin Ahmed ◽  
Subal Rajbongshi ◽  
Najim Hiquemat
Keyword(s):  
Acute Cholecystitis ◽  
Elective Surgery ◽  
Tertiary Care ◽  
Definitive Treatment ◽  
P Value ◽  
Care Hospital ◽  
Early Cholecystectomy ◽  
Delayed Cholecystectomy ◽  
Surgery Group ◽  
Duration Of Surgery

Background: For patients with acute cholecystitis the timing of operative intervention has two broad approaches- early cholecystectomy and elective or delayed cholecystectomy. The main advantage of early cholecystectomy is that, it offers a definitive treatment during the same admission and avoids the problem of failed conservative treatment. The present study is an endeavour to discuss and to compare the outcome of management of acute cholecystitis with early and delayed cholecystectomy.Methods: 100 patients with clinical diagnosis of acute cholecystitis, admitted in the surgical wards of Gauhati Medical College and Hospital during the period of 1st July 2017 to 30th June 2018 were selected for the study. 40 patients underwent early cholecystectomy (within 7 days of onset of symptoms) and 60 patients underwent elective or late cholecystectomy (after a gap of 6-8 weeks from the acute attack).Results: In the present series the average duration of surgery was 90.37±11.96 minutes in the early group and 65.3±7.83 minutes for the elective group which is found to be statistically significant (p value<0.05). In the early surgery group 8.33% required conversion to open surgery. In the elective surgery group 3.63% required conversion. Wound infection, biliary leakage, bile duct injury, and respiratory tract infection was found to be statistically not significant between the two groups.Conclusions: Early cholecystectomy is feasible and safe for acute cholecystitis and is better method of treatment because of its shorter hospital stay, which is a major economic benefit to both the patient and health care system.

scholarly journals Risk Factors Associated with Ischemic Heart Diseases in Different Age Groups Patients of Tertiary Care Hospitals of Peshawar

2015 ◽  
Vol 1 (2) ◽  
pp. 3-9
Author(s):  
Riaz Gul ◽  
Sumaira Naz
Keyword(s):  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Age Groups ◽  
Ischemic Heart ◽  
P Value ◽  
Age Group ◽  
Ischemic Heart Diseases ◽  
Sedentary Life ◽  
Tertiary Care Hospitals

Objectives:To determine different risk factors associated with ischemic heart diseases in different age group patients of tertiary care hospitals of Peshawar.Methodology:A cross sectional study conducted on 350 patients of different age groups presented with ischemic heart diseases in tertiary care hospitals of Peshawar. Study was conducted for duration of 3 months from December 2013 to February 2014. Non probability convenient sampling technique was used. Sample size was calculated using standard sample size calculator. Semi structured questionnaire was used as data collection tool. Patient’s record and investigations were used as adding tools. Standard definition was made for ischemic heart disease. Different modifiable and non-modifiable factors were assessed and were analyzed using SPSS version 16.Results:This study contains 350 patients in which female patients were 133(38%) and male were 217(62%).The mean age was 57.23±11.36 years. The age of the patients ranges from 22 to 80 years. The frequencies of risk factors were stress (73.1%) followed by hypertension (65.7%), sedentary life style (59.4%), family history (57.1%), smoking (50.6%), over weight and obese (39.1%), below normal HDL (30.3%), high LDL (29.1%), hypertriglyceridemia (28%), hypercholesterolemia (23.7%). 64.3% patients were presenting with acute IHD and 35.7% were with chronic IHD. Stress, HTN, DM and sedentary life style were found to be significantly associated with male gender (p- value <0.05). Age was divided into two groups, <45 years and >45 years. Stress, HTN, DM and hypercholesterolemia had a significant association with >45 years of age group. (P-value <0.05).Conclusion:Stress, HTN, DM, sedentary life styles were the major risk factors. And they were found to be more in male gender and in equal to more than 45 years of age group.

scholarly journals Metabolic Risk Factors and Outcomes in Acute Coronary Syndrome

2020 ◽  
pp. 46-50
Author(s):  
Ritu Attri ◽  
Harsimran Kaur ◽  
Raminderpal Singh Sibia ◽  
Mandip Singh Bhatia
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Positive Family History ◽  
Developed Countries ◽  
P Value ◽  
Health Crisis ◽  
Female Ratio ◽  
Medical College ◽  
Coronary Syndrome ◽  
History Of

Introduction: CAD is the most common cause of mortality in India. It is a common multifarious public health crisis today and a leading cause of morbidity and mortality in both developing and developed countries. Hence, understanding the predominant risk factors among the Indian population is important. Materials and Methods: This was a hospital based age and sex matched case control study, carried out at Government Medical College and Rajindra Hospital Patiala. A total of 100 patients of Acute coronary syndrome were studied. Patients and controls were enquired about  the presence of cardiometabolic risk factors and the significance of association of these risk factors with the occurrence of Acute coronary syndrome was given by p value of  <0.05. Results: Majority of the cases were in the age group 61-70 years (32%) with male to female ratio  of 1.25:1. Significant association was found between ACS and risk factors like smoking, positive family history of IHD, hypertension, diabetes, dyslipidemia, waist hip ratio and body mass index. Overall, most common outcome of ACS in the present study was NSTEMI (45%) followed by STEMI (35%) followed by Unstable angina (20%). Conclusion: Significant association was found between smoking and occurrence of STEMI and significant association was found between Hypertension and occurrence of NSTEMI.

scholarly journals Risk factors, clinico-epidemiological profile of tuberculosis among children attending a tertiary care hospital: a two year study

2018 ◽  
Vol 5 (3) ◽  
pp. 851
Author(s):  
Ravikumar Tenali ◽  
Naveen Kumar Badri ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Tertiary Care ◽  
Epidemiological Surveillance ◽  
P Value ◽  
Tuberculous Lymphadenitis ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary ◽  
Epidemiological Profile

Background: TB remains as the one among the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease with 0.4 million with HIV. At least 1 million children become ill with TB each year. Children represent about 10-11% of all TB cases. Having knowledge of the risk factors for tuberculosis infection in children is important to evaluate the level of ongoing transmission of infection and to help adapt activities within national TB control programs. The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Methods: The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Results: 98 cases of TB were confirmed out of total 628 with a prevalence of 17.07% in the   study with 78 PTB cases and 20 EPTB. Females were more with male to female ratio of 0.7:1.5-9 years was the most common age group in the study. Statistically significant association was found between old history of ATT, HIV positivity, contact with an open case of TB and malnutrition (p value<0.05). TB meningitis was the most common EPTB (10/20 cases) followed by tuberculous lymphadenitis (5/20). 69.39% (68/98 cases) were smear positive, radiologically 59.18% of cases were positive and Tuberculin skin test was positive in 46.94%.Conclusions: Childhood tuberculosis is a neglected entity in developing countries due to underreporting and difficulties in diagnosis due to variable clinical picture in children. Hence epidemiological surveillance studies in children are required to determine the actual prevalence of pulmonary and extra pulmonary cases of tuberculosis. Increased efforts are required to isolate TB bacilli from body fluids to identify early the childhood cases and manage them to prevent disease burden in the community.

scholarly journals MATERNAL SEPSIS;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Maternal Morbidity And Mortality ◽  
Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

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