Magnitude, risk factors and outcome of low birth weight babies admitted to neonatal intensive care unit of a tertiary care centre in Puducherry, India

Background: This study was undertaken to know the magnitude, risk factors and outcome of LBW babies admitted in NICU in a tertiary centre.Methods: This is a hospital based, retrospective study, of LBW babies admitted to NICU of Sri Venkateshwara Medical College hospital and research centre, Puducherry, from Jan 2019 - Dec 2019.Results: About 340 babies were admitted to NICU and 56 were LBW babies, 5 were excluded and 51 LBW babies analysed. Magnitude of LBW babies, 51 (15%). Socio demographic pattern showed, IUGR (62.7%). Term IUGR (52%) and preterm IUGR (9.8%). Preterm babies (37.2%). Preterms <28 weeks of gestation (7.8%), 28-34 weeks (9.8%) and 34 to < 37 weeks (19.6%). LBW babies <1kg (7.8%), 1-1.5kg (1.9%) and 1.5 to 2.49 kg (90.1%). Male (52.9%), female babies (47%). LBW babies from rural area (62.7%), urban area (37.2%). Among the maternal risk factors, maternal anemia was common (31.3%). Elderly primi (13.7%), PROM and twin pregnancy in (9.8%) each, bad obstetric history (7.8%). PIH, APH, GDM and oligohydramnios in (3.9%) each. Rh negative pregnancy, grand multipara, teenage pregnancy, ART with hypothyroidism and unbooked pregnancy seen in (1.9%) each. Fetal distress (19.6%). Morbidity was (92.1%). Most common was jaundice (31.9%), sepsis (21.2%). Feeding difficulties (19.1%), TTNB (17%), apnea of prematurity (14.8%). Hypoglycemia and HIE in (12.7%) each. Hypothermia and HMD in (10.6%) each. Seizures in (8.5%) MAS and NEC (4.2%) each, congenital anomalies and hypocalcemia in (2.1%) and mortality in (7.8%). Extreme prematurity, ELBW with sepsis and RDS being common cause of mortality.Conclusions: Iron tablets intake, nutritional care, regular antenatal checkup, spacing pregnancy, avoidance of teenage and elderly pregnancy is important. Improving the infrastructure, manpower in NICU to manage preterm babies, when surfactant and ventilation is given.

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GASTRIC ASPIRATE: A SCREENING TOOL FOR DETECTION OF EARLY NEONATAL SEPSIS-A PROSPECTIVE STUDY IN TERTIARY CARE CENTRE, INDORE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i8.2156 ◽

2021 ◽

Vol 5 (8) ◽

Author(s):

Mansi Gupta ◽

Vivek Singh Kirar ◽

Sanjeev Narang ◽

Swati Prashant

Keyword(s):

Blood Culture ◽

Neonatal Sepsis ◽

Screening Tool ◽

Predictive Accuracy ◽

Tertiary Care ◽

Research Centre ◽

Gastric Aspirate ◽

Tertiary Care Centre ◽

College Hospital ◽

Maternal Risk

Background: Infections in early neonatal period are one of the important factors responsible for high mortality and morbidity in neonates in developing countries. Although it is being frequently observed by pediatricians in neonates, still insufficient relevant studies are documented. The objective of the present study was to evaluate the utility of gastric aspirate cytology as a screening tool for neonatal sepsis, and to determine the polymorphonuclear leukocyte count present in smear of gastric aspirate and correlating it with blood culture proven sepsis. Methods: The study was conducted on 100 neonates suspected with septicemia in inborn patients in Index medical college hospital and research centre. Gastric aspirate sample was collected within 6 hours of birth for septic screening of neonates. All the collected data was statistically analysed by applying Chi-square test using SPSS 2.0 software. Results: Gastric aspirate cytology has sensitivity 0f 53.19% and specificity of 62.28% with positive predictive accuracy of 51.33% and negative predictive accuracy of 63.4%.The relationship between gastric aspirate cytology and maternal risk factors like PROM are found to be highly significant. Conclusions: We conclude that gastric aspirate cytology in neonates is an excellent screening technique for neonatal sepsis added to a detailed perinatal history and clinical examination. The chances of positivity of gastric aspirate increase as the duration of rupture of membranes increased. Keywords: Gastric aspirate cytology, Neonatal sepsis, Blood culture, Polymorphonuclear leukocytes.

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Clinical spectrum of facial hypermelanosis: a descriptive study from a tertiary care centre

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200599 ◽

2020 ◽

Vol 6 (2) ◽

pp. 212

Author(s):

Mohammed Thoyyib ◽

Roshni Menon ◽

Brinda G. David

Keyword(s):

Tertiary Care ◽

Clinical History ◽

Climatic Conditions ◽

Research Centre ◽

Tertiary Care Centre ◽

College Hospital ◽

Pigmentary Disorders ◽

Number Of Patients ◽

The Face ◽

Detailed Clinical History

Background: Facial melanosis (FM) which refers to brown, black or blue pigmentation over the face is a common cosmetic concern in Indian patients. This increased incidence could be due to remarkable diversity of Indian ethinic population. Pigmentary disorders of the face are a great cosmetic and psychological concern for the patients.Methods: This is an extensive descriptive clinico epidemiological study comprising of 1024 patients, conducted at Sri Venkateshwara Medical College Hospital and Research Centre, Puducherry, for a period of one and a half years. A detailed clinical history and examination was done, and all the clinical photographs and data were recorded. Necessary investigations like skin biopsy and patch testing was done wherever required.Results: The maximum number of patients belong to the age group of 21-35 years with a female predominance (67.2%). Among patients of FM, post inflammatory pigmentation (35.3%) was the most common comprising of 362 patients, followed by melasma (17.2%), periorbital melanosis (15.7%), seborrheic melanosis (7.5%) followed by other causes.Conclusions: FM is common in Indian skin, several of which have overlapping features, and some have defined clinical classification. Additionally, climatic conditions, cosmetic usage and social parameters predispose to the increased incidence of FM.

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Morbidity and mortality profile of preterm neonates admitted in neonatal intensive care unit of a tertiary care centre in Western Uttar Pradesh, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193154 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1859

Author(s):

Najia Hassan ◽

Sujaya Mukhopadhyay ◽

Sneha Mohan

Keyword(s):

Risk Factors ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Preterm Neonates ◽

Pregnancy Induced Hypertension ◽

Care Centre ◽

Maternal Risk Factors ◽

Tertiary Care Centre ◽

Maternal Risk ◽

Induced Hypertension

Background: Preterm birth is a major cause of mortality and morbidity for newborns. Complications of prematurity are becoming more common as more survivors are spending time in Neonatal intensive care unit.Methods: A retrospective hospital based clinical observational study was conducted in NICU in Sharda hospital, a tertiary care centre in Greater Noida. Data regarding neonates′ age, sex, clinical presentation, maternal risk factors, complications and outcome were recorded.Results: A total of 133 preterm neonates were enrolled in the study. Maternal risk factors like Pregnancy induced hypertension (PIH) was seen in 19.5% cases, Urinary tract infection in 15% and Antepartum haemorrhage in 14.2% cases. Among the complications of prematurity, RDS was noted in 38.3% cases, Hyperbilirubinemia in 16.5% and feed intolerance in 15% cases. Sepsis was present in 3% of the preterm. Mortality rate was 7.5%. Most common cause of death was RDS.Conclusions: Pregnancy induced hypertension and Antepartum haemorrhage were important maternal risk factors for prematurity. Respiratory distress syndrome and perinatal asphyxia were the important causes of mortality in the present study.

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Anemia in relation to severity of retinopathy of prematurity in preterm babies born in tertiary care centre in South India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204043 ◽

2020 ◽

Vol 7 (10) ◽

pp. 2005

Author(s):

Hrishikesh S. Pai ◽

Rojo Joy ◽

Varghese Cherian ◽

Preethy Peter

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Bronchopulmonary Dysplasia ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Tertiary Care ◽

Oxygen Requirement ◽

Tertiary Care Centre ◽

Potential Risk Factors ◽

Preterm Babies

Background: Retinopathy of prematurity (ROP) is a vaso proliferative disorder of retina among preterm infants. Significant cause of blindness in children with increased survival of premature infants with improved neonatal care. Potential risk factors for development of ROP include low gestational age, low birth weight, bronchopulmonary dysplasia, sepsis, acidosis, oxygen therapy. Anemia as a cause for retinopathy of prematurity has been postulated but there are very few studies addressed the effect of anemia on incidence and severity of ROP. The objective of this study was to determine the effect of anemia on incidence and severity of retinopathy of prematurity and to determine other factors associated with development of retinopathy of prematurity.Methods: Retrospective descriptive study of 120 babies born premature less than 34 weeks for the development of Retinopathy of prematurity and its severity and for associated conditions. All babies screened for retinopathy of prematurity at 3 weeks of age and further followed up for progression of ROP. Factors analysed included hemoglobin levels at 3 weeks of life, number of blood transfusions, days on ventilator, gestational age, birth weight, duration of oxygen requirement, bronchopulmonary dysplasia for the development of retinopathy of prematurity. Findings described in simple descriptive manner.Results: Anemia and increased requirement for blood transfusion are associated with higher incidence and severity of ROP. Low gestational age, birth weight, prolonged oxygen requirement, intraventricular hemorrhage (IVH), sepsis are other risk factors.Conclusions: It is significant to screen preterm babies for ROP and to anticipate in the background of these risk factors. Minimise oxygen duration and blood loss for sampling to prevent anemia and reduce transfusions.

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Surgical Site Infections (SSI) and factors associated in a private tertiary care teaching hospital in Raichur, Karnataka, India

International Surgery Journal ◽

10.18203/2349-2902.isj20183211 ◽

2018 ◽

Vol 5 (8) ◽

pp. 2899

Author(s):

Prashanta Swami Pujar ◽

K. B. Phuleker ◽

Nagaraj Bhalki

Keyword(s):

Risk Factors ◽

Tertiary Care ◽

Surgical Site Infections ◽

Research Centre ◽

Chi Square ◽

College Hospital ◽

Factors Associated ◽

Duration Of Surgery ◽

Chi Square Test ◽

A Prospective Study

Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.

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Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20172516 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1289

Author(s):

Murali Thandavarayan ◽

Sureshkumar Ramaswamy ◽

Priyadarsini Bose ◽

Sivaraman Thirumalaikumarasamy

Keyword(s):

Risk Factors ◽

Status Epilepticus ◽

Tertiary Care ◽

Medical Emergency ◽

Time Of Arrival ◽

Care Hospital ◽

Tertiary Care Centre ◽

College Hospital ◽

Medical College

Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children.

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Prevalence of adenomyosis and associated gynaecological pathologies in hysterectomy samples: a retrospective study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213203 ◽

2021 ◽

Author(s):

Lekshminath Gopinath ◽

Rajani Vaidya

Keyword(s):

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Serous Cystadenoma ◽

Uterine Bleeding ◽

Research Centre ◽

Common Symptom ◽

Age Group ◽

Tertiary Care Centre ◽

College Hospital ◽

Case Record

Background: Adenomyosis is a prevalent gynaecological disorder among women and it is a major cause for AUB. Its diagnosis is confirmed by histological examination of hysterectomized samples. Moreover it is associated with other benign gynaecological pathologies. The aim of this study is to identify the prevalence of Adenomyosis and its association with other benign gynaec pathologies in hysterectomized samples.Methods: This retrospective of two year duration was conducted in obstetrics and Gynaecology department of Malabar Medical College Hospital and Research Centre, a tertiary care centre in Kozhikode, Kerala from 2019 June to 2021 June. 452 patients underwent hysterectomy for abnormal uterine bleeding during this period. Among this, 76 patients had histologically proven adenomyosis in hysterectomy specimen and their case record were reviewed and the data was analysed.Results: The prevalence of Adenomyosis in this study was 16.8%. Majority of women were in age group of 41 to 46 (36.8%), followed by 46 to 50 age group (26.3%). 94 % of women were multipara with majority in para2 and para3 group. Only 6 % of women were nulliparous. Most common symptom was abnormal uterine bleeding (92%), followed by dysmenorrhoea and chronic pelvic pain. Majority had overlap of symptoms. 7% of women were asymptomatic. In 60 % of women no other gynaec pathologies were identified. Most common associated pathology was leiomyoma (15.8%), closely followed by endometriosis (13.2%). Endometrial hyperplasia was associated with adenomyosis in 3.9%of women and endometrial polyp in 2.6%. Ovarian pathologies identified were simple ovarian cyst (2.6%) and serous cystadenoma (1.3%).Conclusions: In the present study, the prevalence of adenomyosis was high and abnormal uterine bleeding was the patients’ most prevalent complaint. Among the associated gynaec pathologies, leiomyoma had the highest correlation with adenomyosis.

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Identification of Maternal Risk Factor with Preterm LBW Babies in a Tertiary Care Hospital

TAJ Journal of Teachers Association ◽

10.3329/taj.v24i2.37511 ◽

2018 ◽

Vol 24 (2) ◽

pp. 95-100

Author(s):

MB Uddin ◽

S Yasmin ◽

M Sanaul Haque ◽

A Hossain ◽

KI Jahan

Keyword(s):

Risk Factors ◽

Tertiary Care ◽

Care Hospital ◽

College Hospital ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Maternal Risk ◽

Medical College ◽

Poor Nutritional Status ◽

Health Related

This study was aimed to identify risk factors of preterm LBW babies by following a cross sectional type of comparative study. This study was conducted at inpatient department of paediatrics of Rajshahi Medical College Hospital from January 2009 to December 2010. A total 150 preterm babies were included in this study. The mothers of the babies were studied to identify some selected risk factors. Maternal poor nutritional status (p<.001), low age at conception (p<.003), poor antenatal care (p<.001) and low level of education (p<.002) were found significant socio-economic risk factors. Maternal health related conditions like Antepartum haemorrhage (p<.001), Premature rupture of the membrane (p<.001), toxemia of pregnancy (p<.005), anaemia (p<.002) all were found as the significant contributors of preterm birth. This study might help to reduce the incidence of mortality and morbidity of preterm infants by providing information regarding risk factors.TAJ 2011; 24(2): 95-100

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CLINICOPATHOLOGICAL PROFILE OF BREAST LESIONS AT TERTIARY CARE CENTRE.

10.36106/ijsr/6005228 ◽

2021 ◽

pp. 64-66

Author(s):

S.K. Nema ◽

Ritika Bharti

Keyword(s):

Tertiary Care ◽

Malignant Lesion ◽

Research Centre ◽

Breast Lesions ◽

Care Hospital ◽

Tertiary Care Centre ◽

College Hospital ◽

Duct Carcinoma ◽

Molecular Features ◽

Study Results

Background: Breast tissue is a modied sweat gland. Breast lesions present with variety of pathological lesions, ranging from inammatory, non- inammatory, non- neoplastic and neoplastic lesions. Breast carcinoma is multifaceted disease comprised of distinct biological subtypes spectrum of clinicopathological, molecular features and different therapeutic and prognostic implications. The present study was designed to evaluate the frequency, age, gender and histopathological features of breast lesions in a tertiary care hospital. Material and Method: The study was conducted in department of pathology, Index medical college hospital & Research centre,Indore. We retrieved breast specimen received in histopathology department over a period of 24 months from June 2018 to June 2020. A total of 106 cases of breast lesions were included in the study. Results: Out of a total of 106 cases of breast lesions, most common lesions were benign 56 (52.83%) with mean age 30.15 years, followed by malignant 50(47.16%) with mean age 48.16 years . The overall mean age of patients was 40.46 years, with a wide age of 11–88 years. Overall the most commonly reported lesion was broadenoma 35 (33.01%) cases, followed by inltrating duct carcinoma 50 (47.16%) cases, mastitis 3(2.8%) cases, Galactocele 3(2.8%) cases. The maximum cases of malignancy were seen in age group more than 40 years of age of life. Most common malignant lesion was inltrating duct carcinoma. Conclusion: The breast lesions pattern revealed by the present study provides valuable information regarding clinicopathological prole of breast lesions.

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Factors predicting difficult laparoscopic cholecystectomy: a single institution experience

International Surgery Journal ◽

10.18203/2349-2902.isj20171632 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1743

Author(s):

Shiv K. Bunkar ◽

Sushil Yadav ◽

Amit Singh ◽

Kalpana Agarwal ◽

Preeti Singh ◽

...

Keyword(s):

Risk Factors ◽

Laparoscopic Cholecystectomy ◽

Tertiary Care ◽

Significant Risk ◽

General Surgeon ◽

Tertiary Care Centre ◽

Chi Square ◽

College Hospital ◽

Symptomatic Gallstones ◽

A Prospective Study

Background: Laparoscopic cholecystectomy is one of the most common operations performed by general surgeon. This study was performed to evaluate pre-operative factors predicting difficult laparoscopic cholecystectomy.Methods: A prospective study was carried out at Jawaharlal Nehru Medical College Hospital, Ajmer, a tertiary care centre in Middle East Rajasthan, India. In present study we included 100 patients diagnosed with symptomatic gallstones disease on the basis of history, clinical examinations and USG findings and underwent laparoscopic cholecystectomy in our hospital by a single surgeon during the period of July 2014 to July 2016. These all patients were evaluated for a group of risk factors and preoperatively these risk factors were given a score between 0-5 labeled as easy, 5-10 as difficult and 11-15 as very difficult. Statistical analysis was done by Fischer’s test and chi square test.Results: BMI >30, previous medical disease like DM, palpable gall bladder, prior hospitalization pericholecystic collection and impacted stone are significant risk factors to predict difficult laparoscopic cholecystectomy.Conclusions: The studied scoring system had a positive prediction value for easy prediction of 94% and for difficult prediction of 100%.

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