scholarly journals Assessment of existing referral system of newborn in Madhya Pradesh, India

2019 ◽  
Vol 6 (4) ◽  
pp. 1466
Author(s):  
Avadhesh Verma ◽  
Ajay Gaur ◽  
Ravi Ambey
Keyword(s):  
Prospective Observational Study ◽  
Newborn Care ◽  
Case Fatality ◽  
Uttar Pradesh ◽  
Madhya Pradesh ◽  
Referral System ◽  
Bed Occupancy ◽  
Medical College ◽  
Optimum Utilization ◽  
One Year

Background: Objectives of present study was to assess receiving system of newborns, bed occupancies of referring facilities and receiving facility and assessment of rationality of referrals made by referring facilities to receiving facility leading to congestion at receiving facility. The study was conducted in Department of Pediatrics, Special Newborn Care Unit, Kamla Raja Hospital, Gajra Raja Medical College, Gwalior, Madhya Pradesh.Methods: This study was a prospective observational study which was conducted for a period of one year. Referred newborns fulfilling inclusion criteria were enrolled in study, and their receiving characteristics, bed occupancies of referring facilities and receiving facility, number of rationale and irrational referrals at receiving facility were statistically analysed.Results: Total referred newborns enrolled in the study was 2000. As receiving SNCU, of institute caters not only its nearby places, but also to distant districts of Madhya Pradesh, Rajasthan and Uttar Pradesh. SNCU wise receiving was in order of SNCU Morar (20.60%), Morena (19.40%), Bhind (5.70%), Dholpur (5.35%), Shivpuri (4.40%), Chattarpur (3.10%), Datia (1.20%), Sheopur (0.40%) and Jhansi (0.30%). Referring SNCU wise bed occupancy was in order of SNCU Guna (189.16%), Shivpuri (154%), Morena (72.33%), Bhind (71.63%), Sheopur (69.32%), Morar (64.15%) and Datia (62.11%). Referring SNCU wise case fatality was in order of SNCU Jhansi (100%), Sheopur (100%), Chattarpur (56.45%), Bhind (38.59%), Shivpuri (35.22%), Morena (33.76%), Dholpur (27.10%), Datia (25%), Morar (22.08%).Conclusions: Discordant bed occupancy at referring SNCU and receiving SNCU and low rationality of referrals are reason for congestion at receiving SNCU. Optimum utilization of beds and cordant bed occupancy between referring and receiving SNCU may improve the working conditions in SNCU and newborn outcome. Referral system should be close loop systemwith the provision of Down Referral.

scholarly journals A prospective observational study conducted in tertiary teaching hospital of Uttar Pradesh to compare safety and efficacy of PPIUCD and interval IUCD (380A)

2018 ◽  
Vol 8 (1) ◽  
pp. 295
Author(s):  
Nidhi Gupta ◽  
Akanksha .
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Uttar Pradesh ◽  
P Value ◽  
Efficacy And Safety ◽  
Puerperal Sepsis ◽  
Medical College ◽  
Tertiary Teaching ◽  
Reversible Method ◽  
Tertiary Teaching Hospital

Background: The objective of this study was to compare the efficacy and safety of PPIUCD and interval IUCD.Methods: This was a prospective observational study conducted on women attending the OPD and indoor services of S.N. Medical college, Agra. 800 women willing for PPIUCD insertion were included in the study after informed consent excluding chorioamnionitis, PROM>18 hours, unresolved PPH and puerperal sepsis. Another 200 willing women were inserted interval IUCD according to MEC criteria of WHO. All were followed up for 1 year.Results: It was found that rate of expulsion was more in PPIUCD group compared to interval IUCD group (6%vs 1.5% p value <.05),rate of removal was almost similar in both groups (11.5%inPPIUCD and 14%in interval IUCD group), cause of removal was mainly social in PPIUCD group while bleeding was more in interval IUCD group compared to PPIUCD (85.7%vs26%).Conclusions: Postpartum insertion of IUCD is a safe effective, feasible and reversible method of contraception.

Characterization and evaluation of Jalauni sheep

2004 ◽  
Vol 34 ◽  
pp. 67-73 ◽  
Author(s):  
G. Sahana ◽  
A. Jain ◽  
S.B. Maity
Keyword(s):  
Management Practices ◽  
Geographical Area ◽  
Morphological Characteristics ◽  
Uttar Pradesh ◽  
Madhya Pradesh ◽  
Barren Land ◽  
Sheep Population ◽  
Permanent Pasture ◽  
And Performance ◽  
One Year

SummaryJalauni sheep are found in the Bundelkhand region of Uttar Pradesh and Madhya Pradesh states in India. About 37% of the geographical area of this region is under cultivation and about 86% of the population, mostly directly or indirectly dependent on agriculture, live in villages. Forests, cultivable waste and barren land occupy more than 50% of the area, permanent pasture and other grazing lands about 9% and miscellaneous tree crops and grasses about 0.7%. The livestock census figures of 1977 and 1997 indicate an annual declining trend of 0.04 % in the sheep population in Uttar Pradesh and Madhya Pradesh states. Characterization and evaluation of Jalauni sheep under field conditions were undertaken to establish the norms, morphological characteristics and performance parameters of this breed. A total of 78 households were visited in 29 villages in five districts. Information on feeding, breeding and management practices, utility patterns etc. and production and reproductive performance was collected through personal observations and interaction with the farmers. Body weight and/or body measurements were recorded for 374 animals. Average adult body weights of male and female Jalauni sheep were 35.5±2.1 and 27.2±0.7 kg respectively. Age at first lambing was 1.5 to 2 years and lambing interval one year. A ewe, on an average, delivers 7–9 lambs in her lifetime.

scholarly journals Study of clinical spectrum of hyperbilirubinemia with frequency of glucose six phosphate dehydrogenase deficiency in neonates

2021 ◽  
Vol 9 (6) ◽  
pp. 1674
Author(s):  
Keshawati Goel ◽  
Anshuman Srivastava
Keyword(s):  
G6pd Deficiency ◽  
Prospective Observational Study ◽  
Dehydrogenase Deficiency ◽  
Uttar Pradesh ◽  
Neurological Deficits ◽  
Medical College ◽  
Abo Incompatibility ◽  
Mucous Membranes ◽  
Rh Incompatibility ◽  
Breast Fed

Background: Jaundice is defined as visible reflexion of serum hyperbilirubinemia on mucous membranes and skin as yellowish discoloration. The frequency of icterus among neonates is about 1 in 2500-5000 live births. When there is disparity between the production of bilirubin, conversion from unconjugated to conjugated bilirubin and excretion of bilirubin results in jaundice. Unconjugated bilirubin is usually harmless but it can also cross blood-brain barrier causing neurotoxicity or kernicterus.Methods: A hospital based prospective observational study which is carried out in the department of paediatrics of Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh from December 2019 to November 2020 on 74 neonates who required admission for hyperbilirubinemia.Results: The most common jaundice occurred in neonates were idiopathic or breastfeeding jaundice as the neonates were breast fed (47.29%). The second most common cause was ABO incompatibility leading to jaundice in 27 (36.48%) neonates. Incidence of neonatal Sepsis, G6PD deficiency, hypothyroidism and cephalhematoma was 22.9%, 4.1%, 2.70% and 4.1% respectively. Polycythemia contributed to 1.35% and the frequency of hyperbilirubinemia in infants of diabetic mother’s or GDM was 10.8%. Rh incompatibility was seen in 13.5%.Conclusions: G6PD deficiency is a significant cause for NNHB and the cases with pathological jaundice if left untreated may lead to severe neurological deficits and lifelong disabilities, hearing impairment, mental retardation, seizures and movement disorders. Hence we recommend G6PD screening in every newborn with significant hyperbilirubinemia to reduce morbidity and mortality.

MECONIUM STAINED LIQOUR AND ITS IMPACT ON PERINATAL OUTCOME

2021 ◽  
pp. 47-49
Author(s):  
Ranjana Sharma ◽  
Manju Agarwal
Keyword(s):  
Prospective Observational Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission ◽  
One Year

Background- The occurrence of meconium-stained amniotic uid (MSAF) during labor has long been considered the predictor of adverse fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia, which leads to perinatal and neonatal morbidity and mortality Methods- A Prospective observational study was carried out in Smt. Hira Kunwar Ba Mahila Hospital, Jhalawar attached to Jhalawar Medical College,over one year from January 2020 to January 2021. Total 278 cases taken at random basis having following inclusion criteria Result- MSL is responsible for neonatal morbidity in 15.1% of cases. Rate of neonatal morbidity was higher in thick meconium group (24.9%) as compared to thin meconium group (6.2%) and this difference was statistically signicant. In our study birth asphyxia (5.8%) was the most common complication followed by MAS (4%), Pneumonitis (3.6%) and Sepsis (1.8%). Conclusion- Passage of meconium still remains as an enigma to the obstetrician and equally worries the paediatrician. As shown in the study, thick meconium is associated with increased operative intervention, low apgar score, increased rate of NICU admission and increased risk of neonatal morbidity and mortality as compared to thin meconium.

scholarly journals Study of Appearances of Ossification Centers in the Carpal Bones in 3 – 14 Years Age Group in a Teaching Hospital in Telangana

2020 ◽  
Vol 7 (48) ◽  
pp. 2811-2814
Author(s):  
Uday Kiran B ◽  
Divya Pothati
Keyword(s):  
Prospective Observational Study ◽  
Skeletal Maturity ◽  
Carpal Bones ◽  
First Year ◽  
X Rays ◽  
Age Group ◽  
Medical College ◽  
One Year ◽  
Ossification Centers ◽  
First Year Of Life

BACKGROUND Study of ossification of carpal bones in children indicates the level of structural maturity and age estimation. For the assessment of skeletal maturity in children, radiologists often use hand and wrist radiograph because of low level of radiation. Carpals are the most commonly used bones for determining the age of a child. We wanted to study the appearance of ossification centers in the carpal bones in age group of 3 - 14 years. METHODS This is a prospective observational study of one-year duration conducted between January 2019 and December 2020 in the Department of Forensic Medicine and Toxicology at Maheshwara Medical College and Hospital, Patancheru, Telangana. Children 3 to 14 years of age from nearby schools were randomly selected, and X-rays of the carpal bones were taken. Appearance of carpal bones and ossification were studied to estimate the age. RESULTS The study included 70 school children. We found that capitate and hamate carpals ossified during the first year of life in children of both sexes. Triquetral and lunate appeared at 3 - 4 years, trapezium, trapezoid and scaphoid carpals appeared between 5 and 8 years. Pisiform appeared at 9 years of age in females and at 13 years in males. CONCLUSIONS Capitate and hamate ossify at an early age. Triquetral and lunate carpals appear after capitate and hamate. Their appearance is slightly earlier in females than in males. KEYWORDS Ossification, Carpal Bones, Capitate, Hamate

scholarly journals Trend of caesarean section at two Government Medical College in Madhya Pradesh, India over one year of time period: a retrospective comparative study

2018 ◽  
Vol 7 (6) ◽  
pp. 2212
Author(s):  
Poonam Mathur ◽  
Alka Patel
Keyword(s):  
Caesarean Section ◽  
Short Circuit ◽  
Madhya Pradesh ◽  
Chi Square ◽  
Medical College ◽  
Tertiary Centre ◽  
Group 2 ◽  
One Year ◽  
Retrospective Comparative Study ◽  
Group 1

Background: There is a massive public interest and debate on both the cause and appropriateness of increasingly employing a surgical procedure to short circuit or entirely bypass labour and delivery. The indications of caesarean sections vary among institutions as there is no standard classification system exists for indications of C-Section. Present study analysed pattern of caesarean section at two tertiary centre in Madhya Pradesh, India.Methods: A structured proforma was filled up for every case and results were recorded on excel sheet. All the cases included in study were further divided in group 1 (deliveries conducted in year 2014-2015 at Govt. Medical College Indore, M.P.), group 2 (deliveries conducted at Govt. Medical College Rewa at same time. Comparative analysis between study group1 and group 2 was done using Pearson Chi square test.Results: In group 1 there were 10525 deliveries out of which 3705 were delivered by caesarean section (35.2%), in group 2 there were 8674 deliveries out of which 1182 were delivered by caesarean section (13.6%). This difference in caesarean section at both medical college may be due to the more no. of referrals from the periphery to the medical college Indore and having more no of private institutions and district hospital which cater the normal delivery.Conclusions: There is a reliable and reproducible framework is required for audit and analysis of Caesarean section trends in specific obstetric subgroups to permit comparisons of practice between different institutions and over time in the same institution.

scholarly journals Profile and pattern of obstructive jaundice cases from a tertiary care teaching hospital of Uttar Pradesh

2017 ◽  
Vol 4 (2) ◽  
pp. 743
Author(s):  
Ashok Kumar Gupta ◽  
Abhishek Singh ◽  
Shwetank Goel ◽  
Rakesh Tank
Keyword(s):  
Obstructive Jaundice ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Madhya Pradesh ◽  
Modes Of Presentation ◽  
Benign Biliary Strictures ◽  
Common Causes ◽  
Study Population ◽  
One Year ◽  
Loss Of Appetite

Background: The common etiologies of obstructive jaundice have been reported to vary from one centre to another and from one individual to another. Only a very few studies have been conducted on this topic and none from the state of Madhya Pradesh, India. The present study was planned to study the profile and pattern of obstructive jaundice cases in the region of Madhya Pradesh, India.Methods: A retrospective cohort of patients with obstructive jaundice admitted to SRMS Institute of Medical Sciences, Bareilly, Uttar Pradesh, India during past one year i.e. January to December 2014 formed the study population. In this study, all the eligible patients positively diagnosed as extrahepatic obstructive jaundice were included in this study. Study tools were records of the patients such as information/records from MRD department and clinical case sheets.Results: Malignant causes (63.89%) were more frequent than benign causes (36.11%). More than 50% cases were in the age group of 55-75 years. Sex wise males outnumbered females. Among the malignant causes of obstructive jaundice, cancer head of pancreas (60.87%) and cholangiocarcinoma (17.39%) were common causes whereas among the benign causes of obstructive jaundice, choledocholithiasis (76.92%) and benign biliary strictures (15.38%) were common causes.Conclusions: Jaundice (91.67%), loss of appetite (77.78%) and pain abdomen (75%) were three most common modes of presentation of obstructive jaundice cases.

scholarly journals Predictors in profile of referred newborns for their outcome in a tertiary newborn referral facility

2018 ◽  
Vol 6 (1) ◽  
pp. 87
Author(s):  
Avadhesh Verma ◽  
Ajay Gaur ◽  
Ravi Ambey
Keyword(s):  
Respiratory Distress ◽  
Prospective Observational Study ◽  
Referral System ◽  
Physiological Profile ◽  
Neonatal Deaths ◽  
Independent Variables ◽  
Physiological Variables ◽  
Standard Management ◽  
Mode Of Transport ◽  
One Year

Background: This study was aimed to assess newborn referral and factors contributing to outcome of referred newborns.Methods: This prospective observational study was conducted in a tertiary newborn referral facility for a period of one year. Referred newborns fulfilling inclusion criteria were enrolled in study, and assessed in terms of demographic profile, transport characteristics, physiological variables. Investigations, management of neonatal illness was done as per standard management protocols, they were followed up to their outcome.Results: Out of 2000 enrolled referred newborns, 30.10% were expired. Mean gestational age for survived newborns was 36.54±2.92 (SD) weeks, for expired newborns 35.24±3.99 (SD) weeks. Mean weight for survived newborns 2312.27 gms ±555.71 (SD), for expired newborns 1936.71 gms ±665.67 (SD). Out of total 60.05% newborns transported from periphery, had higher mortality i.e. 35% as compared to newborns transported from urban place i.e. 25%. Mean transport duration for survived newborns 61.94 minutes ±55.18 (SD), for expired newborns 89.51 minutes ±88.94 (SD). Prolonged CRT was observed  in 57.45% newborns, grunting   19.70%, Cyanosis 11%, gasping 7.6%, apnea 5%, respiratory distress 39.80%, hypothermia 74.95%, and 25.50% required resuscitation on admission. Unattended delivery, self-arranged mode of transport, prolonged CRT, respiratory distress, apnea , hypothermia on admission, weight on admission(<1500gms), hypoglycaemia and duration of transport more than 1 hour  found statistically significant independent variables associated with mortality of referred newborns.Conclusions: A significant number of neonatal deaths can be prevented, if referral system is structured and organized. Improper referral leads to poor physiological profile of referred newborns, which leads to their poor outcome. There are many independent variables which are affecting the outcome of referred newborns. These independent variables can be taken care in holistic way once the referral system is cultured and nurtured in existing health system.

scholarly journals Timely relaparotomy after caesarean section of a moribund patient can save the life

2015 ◽  
Vol 23 (1) ◽  
pp. 41-47
Author(s):  
Mukti Rani Saha ◽  
Iffat Ara ◽  
Suvash Chandra Roy ◽  
Tapan Kumer Saha ◽  
Nandita Paul ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Rectus Sheath ◽  
Case Fatality ◽  
Near Miss ◽  
College Hospital ◽  
Medical College ◽  
Primary Surgery ◽  
Internal Iliac ◽  
One Year

The aim of this study was to find out the outcome of cases requiring relaparotomy following caesarean delivery during the puerperium. This was a retrospective descriptive study set in a tertiary referral and teaching hospital i.e. Dhaka Medical College Hospital, Dhaka. Over a period of one year from January 1st to 31st December 2010, there were 5027 caesarean deliveries (53%-94%) out of a total of 9320 deliveries. Relaparotomy was done in 48 patients (0.95%) of the caesarean sections. The indications of repeat laparotomy were secondary postpartum haemorrhage (PPH) in 28 cases (58.33%), primary PPH due to uterine atony in 15 cases (31.3%), uterine sepsis with haemorrhage in 2 cases (4.17%), rectus sheath haemotoma in 2 cases (4.13%), internal haemorrhage after caesarean section in 1 case (2.08%). Of these 48 cases, in14 cases, primary caesarean section was done in this institution while 34 had caesarean delivery at other hospitals and clinics at (13 cases) and outside Dhaka (21 cases). Main surgeries performed at relaparotomy were subtotal hysterectomy in 29 cases, total hysterectomy in 9 cases, drainage of haematoma and peritoneal toileting in 4 cases, resuturing of uterine incisions in 5 cases, internal iliac arteries in 1 case. More than one procedure was often performed in one case. There were 6 maternal deaths following relaparotomy caused by shock following PPH, septicaemia and internal haemorrhage. Repeat laparotomy within six weeks of caesarean delivery was required 1 in 200 cases in this institute. Case fatality rate was (12.5%). Near miss fatalities were common. Majority on these were preventable. Identification of risk factors, adequate attention during primary surgery, expert decision, prompt intervention and proper case management during relaparotomy will improve the outcome. Centers carrying out caesarean section should have efficient blood transfusion service in the first place. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22693 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 41-47

EPIDEMIOLOGY OF PEDIATRIC BURNS IN TERTIARY CARE CENTER OF VINDHYA REGION OF MADHYA PRADESH

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Vinit Kumar Tiwari ◽  
Saurabh Saxena
Keyword(s):  
Economic Status ◽  
Care Center ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Madhya Pradesh ◽  
Older Children ◽  
Low Socioeconomic ◽  
Medical College ◽  
Pediatric Burns ◽  
One Year

This retrospective review contains 100 paediatric burns up to 14 yrs of age admitted to the Burn unit of the Department of surgery, SS Medical College, Rewa Madhya Pradesh. over a period of one year from January 2019 to December 2019.Epidemiological data include age sex, seasonal variation, place of burn, family size, economic status, period of time between the accident and admission to hospital. The cause and mode of burn, the relationships between mortality and age, cause of burn and extent of burn are discussed. Most of the burn injuries occurred in the winter months between November and February. Males were affected predominantly. The majority of burns occurred at home. Most of the patients belonged to the low socioeconomic strata. The commonest causes of injury were scalds in children under 5 yrs of age and flames in the older children. The overall mortality was 18 % percent.

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