scholarly journals Clinical profile and outcome of neonates admitted in sick newborn care unit with hypernatremic dehydration and association with breastfeeding in a tertiary care hospital in Northern India

2021 ◽  
Vol 8 (6) ◽  
pp. 1074
Author(s):  
Mohit Bajaj ◽  
Chiranth R. ◽  
Swati Mahajan ◽  
Pancham Chauhan
Keyword(s):  
Sodium Level ◽  
Tertiary Care ◽  
Newborn Care ◽  
Main Step ◽  
Care Hospital ◽  
Sick Newborn ◽  
Hilly Region ◽  
The Mean ◽  
Time Of Admission ◽  
Hypernatremic Dehydration

Background: Neonatal hypernatremic dehydration is a very commonly seen potentially devastating condition. Inadequate breastfeeding, gastrointestinal losses, warm weather and improperly diluted mixed feeding are the main etiologies linked with neonatal hypernatremic dehydration. We conducted this study to evaluate the etiology, risk factors, clinical symptoms and outcomes of neonates admitted with hypernatremic dehydration and its association with breastfeeding from hilly region in northern India.Methods: The authors retrospectively studied records from extramural sick newborn care unit (SNCU) from April 2018 to June 2019. Inclusion criteria for the study included admitted neonates with documented hypernatremia (serum sodium level >145 mmol/L). Results: Nine hundred and twenty-two neonates were admitted in sick newborn care unit during this study period. One hundred and three (13.39%) newborns were admitted with hypernatremic dehydration at the time of admission. All newborns had deranged kidney function tests at time of admission. Most commonly found presenting complaints were poor feeding (85.71%), fever (45.71%), loose stools (42.8%) and decreased urine output (8%). The mean (SD) sodium on admission was 154.04 (7.41) meq/L. The mean (SD) time taken to correct hypernatremia was 35.6 (14.6) hours. Six of total admitted newborn developed neurological complications (2 had developed cerebral venous thrombosis and 4 had developed seizures). Mortality rate was 4.4%. Top fed neonates (50.41%) had higher percentage of mean sodium level and acute kidney injury at time of admission.Conclusions: Hypernatremic dehydration is preventable and treatable condition. Looking in to and addressing etiology in a timely manner is main step in management. All mothers should be taught correct breastfeeding technique. More breast examination during prenatal and postnatal periods and careful neonatal weight record postnatally could decrease the incidence of neonatal hypernatremic dehydration. Top feeding should be discouraged and only exclusive breastfeeding for 6 months. 

First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Age Group ◽  
Number Of Patients ◽  
The Mean ◽  
Collection Form ◽  
Time Of Admission ◽  
Second Wave

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

scholarly journals Cord Care Methods in Neonates

2021 ◽  
Vol 15 (10) ◽  
pp. 3509-3510
Author(s):  
Andleeb Kanwal ◽  
Zahid Anwar ◽  
Mateen Akram ◽  
Shahid Anwar ◽  
Saima Pirzada
Keyword(s):  
Urban Areas ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Newborn Care ◽  
Hospital Staff ◽  
Care Hospital ◽  
Cord Care ◽  
Level 3 ◽  
The Mean ◽  
Nurses And Midwives

Background: Proper cord care methods in neonates have been known to reduce infections, sepsis, and death. This study intends to document the frequency of cord care methods. Methods: A questionnaire-based study was done in 6 months in a tertiary care hospital with a level 3 nursery and NICU (Fatima Memorial Hospital, Lahore). We interviewed mothers and female companions of neonates in wards and outpatient clinics. Answers were added to SPSS in socio-demographic categories and cord care methods. Result: A total of 778 females were interviewed. The mean age is 28 + 8.1 years, mostly educated (90%) and resided in urban areas (83%). 39.4% of the participants had personal experience of newborn care. Most were housewives (74.4%). 36.8% would not apply anything to the cord, but the other majority would apply some agent to the newborn cord, methylated spirit being the favourite (48.5%), remaining being mostly antibiotics and antimicrobial agents. Chlorhexidine was used only by one participant. Doctors and nurses had counselled 70% of the participants, but 10% listened to the advice of relatives and grandmothers. 18.5% declined any knowledge of safe practices. Conclusions: Our study emphasizes the need to educate our hospital staff (doctors, nurses and midwives) as well as family members of neonates with standardised cord care methods. Keywords: Neonates, Cord care, Umbilical cord,Methylated spirit.

scholarly journals Prescribing pattern of drugs in sick newborn care unit in a tertiary care hospital, Haldwani, Uttarakhand, India

2017 ◽  
Vol 6 (4) ◽  
pp. 832
Author(s):  
Pooja Agrawal ◽  
Bhavana Srivastava ◽  
Sanjay Gaur ◽  
Renu Khanchandani ◽  
Bithorai Basumatary
Keyword(s):  
Drug Utilization ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Case Fatality ◽  
Current Data ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
New Born ◽  
Sick Newborn

Background: Sick Newborn Care Unit (SNCU) is meant to reduce the case fatality among sick newborns. Although it has been shown that patterns of drug utilization in SNCU are changing dynamically, current data on drug utilization patterns in SNCU is limited. This study was done to find out drug utilization pattern in newborn admitted at SNCU.Methods: This prospective observational drug utilization study was carried out in SNCU of Government Medical College and Hospital, Haldwani (Uttrakhand). The pattern of drug use in 206 sick newborn admitted at SNCU was assessed.Results: 75.25% sick newborns were in early neonatal period and 63.11% sick newborns were male. 33.98% sick newborn were preterm and mean±SD of weight of sick newborn was 2.16±0.6kg. Neonatal sepsis was commonest reason for admission followed by birth asphyxia . Three or more drugs (average 2.35drug/ Range 3-9 drug) were given to 52.91% new born and two drugs were given to 40.78% new born. Commonest route of drug administration was intravenous (97.08%), followed by intramuscular (72.82%), followed by orally (13.59%) and 11.65% new born received drug by inhalation. Most frequently used drugs in SNCU were antibiotics (Ampicillin, Gentamicin, Amikacin, Cefotaxime). Only two adverse drug reactions (mild rash by ampicillin and fever) were reported during study period. Out of 206 sick newborn, 18.93% died. Most common causes for death were respiratory distress syndrome (41.03%) followed by sepsis (23.08%) and hypoxic ischemic encephalopathy (17.95%).Conclusions: Antibiotics were of major concern in SNCU. The uncertainty regarding the choice of antibiotic can be minimized by periodic survey of etiological agent and their antibiotic susceptibility pattern.

scholarly journals Obstetric outcome in twin gestation with reference to chorionicity

2017 ◽  
Vol 6 (11) ◽  
pp. 4908
Author(s):  
Lekshmi Murukesan ◽  
Mayadevi Brahmanandan ◽  
Sujamol Sujamol Jacob
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Newborn Care ◽  
First Trimester ◽  
Care Hospital ◽  
Adverse Perinatal Outcome ◽  
The Mean ◽  
Twin Pregnancies

Background: Monochorionic twin pregnancies are at greater risk for growth abnormalities and other complications. This study aims to outline the obstetric problems faced by twins in general and also to determine the influence of chorionicity on pregnancy and perinatal outcome in twins. Objective of present study was to compare the obstetric and perinatal outcome between monochorionic and dichorionic twins.Methods: A clinical non-interventional prospective observational study was conducted in a tertiary care hospital over a period of 1 year. 232cases of twin pregnancies were followed up from first trimester. The antepartum complications, mode of delivery, presentation, pregnancy outcome, condition of babies and perinatal mortality were compared between mono-chorionic and dichorionic twins.Results: Among 232 cases of twins studied, 2/3rd were dichorionic and 1/3rd were monochorionic. The mean gestational age for Monochorionic (MC) twins was 33.2 weeks whereas it was 35.6 weeks for Dichorionic (DC) twins. Preterm delivery was significantly associated with mono-chorionicity. Elective CS was done more for MC twins compared to DC twins. The mean birth weight of MC twins was 1.7 kg compared to 2.1 kg among DC twins. Low APGAR scores were seen in 31.3% of MC twins compared to 15.8% of DC twins. The number of asphyxiated babies (12.5%), stillborn (7.5%) and macerated babies (10%) were more in MC group in comparison to DC group where it was (9.9%, 2.1%, 0.7%) respectively. Risk of IBN admissions were more in MC than DC twins. (31.3% Vs 21.1%) Adverse perinatal outcome was associated more with MC pregnancies (37.5%) than DC. (11.8%).Conclusions: Mono-chorioncity was significantly associated with pregnancy complications and adverse perinatal outcome. Hence early diagnosis of chorionicity and referral to a tertiary centre with fetal medicine unit and newborn care is very important in reducing morbidity and perinatal mortality among MC twins.

scholarly journals Delivery point immunization in tertiary care hospital in Eastern India and challenges

2019 ◽  
Vol 6 (5) ◽  
pp. 1886
Author(s):  
Bharati Das ◽  
Puspanjali Khuntia ◽  
Lucy Das ◽  
Jayashree Pattnaik
Keyword(s):  
Vaccine Coverage ◽  
Tertiary Care ◽  
Newborn Care ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Time Period ◽  
Sick Newborn ◽  
Birth Dose ◽  
Hep B

Background: Hepatitis B is a major public health problem. The efficiency of the vaccine decreases as the time period between the birth and first dose increases. “WHO recommends that all infants should receive their first dose of Hep B vaccine as soon as possible after birth, preferably within 24 hrs. In India the birth dose/ 0 dose coverage was 45% on 2015. Prior to initiation of “Delivery Point Immunization” the birth dose Hep B was 35%. During the course of this programme the challenges and problems faced has been addressed in this study.Methods: It is a prospective observational study for a period of 15 months conducted by postpartum programme department in O&G department. It includes all the babies delivered in the department.Results: After the integration of delivery point immunization with JSY (Janani Surakhya Yojana) programme, the 0 dose hep B coverage was 72%.The coverage of BCG and 0dose OPV remained 89.48%.The most modifiable cause due to which babies were not received 0 dose Hep B vaccine was due to ignorance 36.19% and babies not received due to SNCU (Sick Newborn Care Unit) admission was 36.06%.Conclusions: Initiation of delivery point immunization has definitely increased the 0 dose hep B vaccine coverage. Integration with other maternal and child health programme had further increased the coverage. Though significant percentage of people know about the at birth immunization but are ignorant about the timing of 0 dose hep B vaccine.

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

2021 ◽  
Vol 8 ◽  
pp. 204993612110365
Author(s):  
Kundan Mishra ◽  
Suman Kumar ◽  
Sandeep Ninawe ◽  
Rajat Bahl ◽  
Ashok Meshram ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Febrile Neutropenia ◽  
Burkholderia Cepacia ◽  
Myeloid Leukemia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
The Mean ◽  
Acute Myeloid

Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

scholarly journals Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital

2013 ◽  
Vol 5 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Sunita Hemani ◽  
Premlata Mital
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Care Hospital ◽  
Barrier Method ◽  
Unintended Pregnancies ◽  
Attitude And Practice ◽  
Complete Knowledge ◽  
The Mean ◽  
Medical Healthcare

ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

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