scholarly journals A retrospective analysis of mid trimester termination of pregnancies for fetal congenital malformations at tertiary care hospital

Author(s):  
Geethalakshmi Suriyanarayanan ◽  
Vijayalakshmi Kandasamy ◽  
Anuradha Coimbatore Ramachandran

Background: This study was conducted to analyse the spectrum of fetal anomalies as a cause of pregnancy termination in a tertiary care hospital.Methods: This retrospective study includes antenatal women with fetal anomalies diagnosed by an ultrasound (USG) and admitted in Chettinad Hospital and Research Institute, Kelambakkam from January 2018 to January 2020 for termination of pregnancy. Data was collected from hospital records and analysed.Results: Gestational age of women with fetal congenital anomalies ranged from 13 to 21 weeks. Pregnancy termination, was performed between 17-19 weeks of gestation in 41% of patients, between 13-15 weeks and 19-21 weeks in 23% of women respectively. Congenital fetal anomalies resulting in termination of pregnancy were CNS, musculoskeletal, cardiovascular, renal and multiple anomalies. CNS abnormalities was a major cause of termination of pregnancy which includes meningomyelocele, spina bifida, acrania, anencephaly.Conclusions: In our study conducted at our tertiary care center, CNS abnormalities were the major cause of mid trimester termination of pregnancies, followed by musculoskeletal abnormalities being second most common cause.

Author(s):  
Nithya Venkataramani ◽  
Ravi Sachidananda ◽  
Sandeep Dachuri ◽  
Srividya Rao Vasishta

<p class="abstract"><strong>Background:</strong> Adenoidectomy is conventionally performed using adenoid curette as a blind procedure. Suction diathermy adenoidectomy is a technique of ablating the adenoid tissue using thermal energy and removing it by suction. This audit aims to study the efficacy and complications of this technique in a tertiary care center.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of hospital database was conducted. Twenty-seven patients who underwent suction diathermy adenoidectomy were identified and hospital records studied. Parents were contacted and enquired regarding improvement in child's symptoms.</p><p class="abstract"><strong>Results:</strong> No instances of postoperative complications identified. All except 2 parents were completely satisfied with the improvement in their child's symptoms. Two children had occasional mouth breathing.</p><p class="Standard"><strong>Conclusions:</strong> Suction diathermy adenoidectomy is a feasible alternative to conventional adenoidectomy with few complications and minimal rate of recurrence.</p>


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


1998 ◽  
Vol 19 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Mary V. Singer ◽  
Rachel Haft ◽  
Tamar Barlam ◽  
Mark Aronson ◽  
Amy Shafer ◽  
...  

ABSTRACTOBJECTIVE: Evaluate vancomycin prescribing patterns in a tertiary-care hospital before and after interventions to decrease vancomycin utilization.DESIGN: Before/after analysis of interventions to limit vancomycin use.SETTING: 420-bed academic tertiary-care center.INTERVENTIONS: Educational efforts began August 10, 1994, and involved lectures to medical house staff followed by mailings to all physicians and posting of guidelines for vancomycin use on hospital information systems. Active interventions began November 15, 1994, and included automatic stop orders for vancomycin at 72 hours, alerts attached to the medical record, and, for 2 weeks only, computer alerts to physicians following each vancomycin order. Parenteral vancomycin use was estimated from the hospital pharmacy database of all medication orders. Records of a random sample of 344 patients receiving van-comycin between May 1, 1994, and April 30, 1995, were reviewed for an indication meeting published guidelines.RESULTS: Vancomycin prescribing decreased by 22% following interventions, from 8.5 to 6.8 courses per 100 discharges (P<.05). The estimated proportion of van-comycin ordered for an indication meeting published guidelines was 36.6% overall, with no significant change following interventions. However, during the 2 weeks that computer alerts were in place, 60% of vancomycin use was for an approved indication.CONCLUSIONS: Parenteral vancomycin prescribing decreased significantly following interventions, but the majority of orders still were not for an indication meeting published guidelines. Further improvement in the appropriateness of vancomycin prescribing potentially could be accomplished by more aggressive interventions, such as computer alerts, or by targeting specific aspects of prescribing patterns.


2015 ◽  
Vol 06 (04) ◽  
pp. 515-519 ◽  
Author(s):  
Chaitali Patra ◽  
Shatanik Sarkar ◽  
Debasree Guha ◽  
Malay K. Dasgupta

ABSTRACT Background: The clinical pattern and etiology of stroke may vary over time or with geographical location. In Asian countries, specific etiology and outcome of childhood stroke have been rarely reported. Objective: To determine the clinical and etiological pattern of childhood stroke and their outcome in a Tertiary Care Center. Materials and Methods: This study was conducted in a Tertiary Care Hospital of Kolkata over a period of 3 years. All children from 6 months to 12 years, diagnosed as childhood stroke by radio-imaging were included in our study. Children presenting with paraplegia/paraparesis were excluded. Etiologies were determined on the basis of clinical examination, related blood investigations and radio-imaging findings. Data gathered from the stroke patients were entered into a preformed proforma and appropriate statistical analyses were done. Result: Most commonly found clinical presentation was hemiparesis (70.6%). Next in place was a seizure (61.8%) and alteration of consciousness (58.8%). The most common etiology of childhood stroke in our hospital was found to be an intracranial infection (41.2%), followed by vascular etiology. Stroke was ischemic in nature in 91.2% of cases. Among the clinical features, vomiting, alteration of sensorium, and fever were significantly (P < 0.01) more in infectious cases of stroke, but hemiparesis was significantly (P < 0.05) more common in noninfectious etiology. Most of the cases of noninfectious etiology (95%) completely recovered without any persistent neurodeficit or mortality. Conclusion: Intracranial infection is the commonest etiology of stroke in pediatric patients presenting at our hospital. Commonest type is an ischemic stroke. The most of the patients completely recovered from the acute neurological insult after proper and timely management.


2013 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Md Motiul Islam ◽  
Mirza Nazim Uddin ◽  
ARM Nooruzzaman ◽  
Rahan Rabbani ◽  
Ahmad Mursel Anam ◽  
...  

NIV is a method of ventilatory support which is delivered to the patient without using an invasive airway. For the last two decades it is increasingly used as an accepted method of mechanical ventilatory support as it is proved to have many positive outcomes as it can prevent invasive ventilation & its complication. In a tertiary care hospital of Bangladesh we are using this method in all patients meeting the NIV criteria & not having absolute contraindication irrespective of diagnosis. Our study aimed to access the out come of the NIV trial using our local resource & to compare it with others. This is an ongoing prospective study and till this report data from 82 patients were analyzed here of which 50% patient ended with positive outcome & 50% ended as negative outcome. As the result of this method varies significantly by diagnosis & severity of disease we are generating specific recommendations according to the likely outcome according to the diagnosis. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14358 Bangladesh Crit Care J March 2013; 1: 3-7


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