scholarly journals A study of risk score assessment in antenatal women and their neonatal outcome in a tertiary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 212-219
Author(s):  
Amit Kumar ◽  
P. Sindhusha ◽  
P.J.N. Satyavathi ◽  
N. Pragnasai ◽  
P. Deepika ◽  
...  
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Neonatal Outcome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Group ◽  
Risk Category ◽  
Study Group ◽  
Care Hospital ◽  
Maternal Complications

A high-risk pregnancy is any condition associated with a pregnancy where there is an actual or potential risk to the mother or fetus. Risk assessment is a key component of antenatal care (ANC) and has demonstrated benefits in improving maternal and perinatal outcomes. To assess maternal complications that occurs in antenatal women and their neonatal outcomes in a tertiary care hospital.200 antenatal women, admitted to obstetrics & gynaecology department from 16-09-2020 to 15-03-2021 were evaluated. Antenatal women with maternal complications (Gestational hypertension, preeclampsia, Gestational diabetes, Hypothyroid, Anaemia, Asthma and oligohydramnios) were taken into study group and women with no complications were taken into control group. The risk factors were assessed and risk scores were determined by Dutta and Das scoring system and Hobel risk scoring system. It was found that there was a significant association between poor neonatal outcome and high-risk pregnancies. The incidence of preterm births is higher in the study group (34.1%) when compared with the control group (13.7%). Mode of delivery was predominantly by caesarean section in the study group (p<0.005). Neonatal complications were significantly more (p<0.05) in study group and fetal distress was exclusively seen in the study group (p<0.0005). Maternal complications such as eclampsia correlated significantly with the risk score (p=0.005). Neonatal outcomes such as Low birth weight (p<0.0001) were higher in the high-risk category when compared to the low risk and moderate risk category. There was a significant correlation between high-risk antenatal and poor neonatal outcome. Scoring systems, such as the one used in our study, can be adopted at primary and rural health centres even by a non-medical counsellor as a screening tool to predict pregnancies at high risk for poor neonatal outcome, thereby facilitating early referral of these women to tertiary care centres.

scholarly journals Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Severe Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Antibody Therapy ◽  
Additional Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

scholarly journals The effect of care transition pathway implementation on patients undergoing joint replacement during the COVID-19 pandemic: a quasi-experimental study from a tertiary care hospital orthopedic department in Beijing, China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ya-ping Xu ◽  
Pei-yu Zhao ◽  
Yi-tong Bai ◽  
Shuang Li
Keyword(s):  
Joint Replacement ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Transition ◽  
Control Group ◽  
Care Hospital ◽  
Quasi Experimental ◽  
And Control ◽  
Beijing China

Abstract Background The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. Methods A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. Results The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. Conclusions A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.

ALKALINE PHOSPHATASE AS A PROGNOSTIC MARKER IN CANCER BREAST PATIENTS IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 14-16
Author(s):  
Asha Premlata Omega Oraon ◽  
Bela Rose Ekka
Keyword(s):  
Alkaline Phosphatase ◽  
Cancer Patients ◽  
Prognostic Marker ◽  
Prognostic Markers ◽  
Tertiary Care Hospital ◽  
Serum Alkaline Phosphatase ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Cancer Breast

OBJECTIVE: To estimate the value of Alkaline Phosphatase in cancer breast patients in a tertiary care hospital. MATERIAL AND METHODS: The study was conducted to estimate the value of Serum Alkaline Phosphatase in 50 cancer breast patients and 50 normal patients of same age as a control group. RESULTS: The level of serum Alkaline Phosphatase was signicantly increased (p<0.05)in cancer patients compared to the control group. CONCLUSION: There is an increase in serum Alkaline Phosphatase in cancer patients compared to the control group and can be a prognostic markers for the progress of the disease.

A RETROSPECTIVE ANALYSIS OF MATERNALAND FETAL OUTCOMES OF PRETERM DELIVERIES IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA.

2021 ◽  
pp. 42-44
Author(s):  
Varsha Konyala ◽  
Poornima M ◽  
Suma K.B
Keyword(s):  
Preterm Delivery ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Preterm Births ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Maternal Complications ◽  
Record Keeping

Aim:To study preterm delivery outcomes in a tertiary care hospital in South India. Methods: The study was conducted for a 7 month period from July 1, 2020 to January 31, 2021at JSS Hospital, Mysuru. Relevant details of every pregnant woman who underwent a preterm delivery and the subsequent neonate born were collected and followed till discharge. Results: The prevalence rate of preterm births was 11.81%. There were 44 early preterm deliveries and 88 late preterm deliveries. The most common maternal complications that lead to preterm births PPROM and preeclampsia.36 early preterm and 29 late preterm neonates required an NICU admission. This included 7 pairs of twins in the early preterm and 1 pair of twins in the late preterm. In the NICU, the most common complications noted were RDS, and sepsis.4 neonates remained by mother's side soon after delivery in the early preterm subset, whereas 54 of late preterm neonates were kept by the mother's side soon after delivery. 31 of 40 early preterm, 86 of the 88 of late preterm neonates were healthy and t for discharge. Conclusion:The prevalence of preterm birth rate in our study stands comparable to the reported global average. Preterm births have a multifactorial etiology. Timely referral to higher centers, experienced obstetricians, and a good NICU facility proved helpful to both the mother and neonate. Thorough record keeping also allows a true picture of preterm prevalence on the basis of which, policies and decisions can be made to further improve preterm care.

scholarly journals Extensively Drug-Resistant Hypervirulent Klebsiella pneumoniae From a Series of Neonatal Sepsis in a Tertiary Care Hospital, India

2021 ◽  
Vol 8 ◽  
Author(s):  
Tuhina Banerjee ◽  
Jayalaxmi Wangkheimayum ◽  
Swati Sharma ◽  
Ashok Kumar ◽  
Amitabha Bhattacharjee
Keyword(s):  
Klebsiella Pneumoniae ◽  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Plasmid Profile ◽  
Care Hospital ◽  
Drug Resistant ◽  
Maternal Complications ◽  
Extensively Drug Resistant ◽  
Recent Emergence

The recent emergence of multidrug-resistant (MDR) Klebsiella pneumoniae with hypervirulent traits causing severe infections and considerable mortality is a global cause for concern. The challenges posed by these hypermucoviscous strains of K. pneumoniae with regard to their optimal treatment, management, and control policies are yet to be answered. We studied a series of extensively drug-resistant (XDR) and hypervirulent K. pneumoniae ST5235 isolates with resistance to carbapenems and polymyxins causing neonatal sepsis in a tertiary care hospital in India. A total of 9 K. pneumoniae isolates from 9 cases of neonatal sepsis were studied with respect to their clinical relevance, antimicrobial susceptibility profile, presence of extended spectrum β lactamase (ESBL) production, and responsible genes, carbapenemases (classes A, B, and D), and aminoglycoside-resistant genes. Hypervirulence genes encoding hypermucoid nature, iron uptake, and siderophores were detected by multiplex PCR. The plasmid profile was studied by replicon typing. Isolates were typed by multilocus sequence typing (MLST) and enterobacterial repetitive intergenic consensus (ERIC) PCR to study the sequence types (STs) and clonal relation, respectively. The neonates in the studied cases had history of pre-maturity or low birth weight with maternal complications. All the cases were empirically treated with piperacillin–tazobactam and amikacin followed by imipenem/meropenem and vancomycin and polymyxin B as a last resort. However, all the neonates finally succumbed to the condition (100%). The studied isolates were XDR including resistance to polymyxins harboring multiple ESBL genes and carbapenemase genes (blaNDM and blaOXA−48). Hypervirulence genes were present in various combinations with rmpA/A2 genes present in all the isolates. IncFI plasmids were detected in these isolates. All belonged to ST5235. In ERIC PCR, 6 different clusters were seen. The study highlighted the emergence and burden of XDR hypervirulent isolates of K. pneumoniae causing neonatal sepsis in a tertiary care hospital.

“A TRUE EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF XYLOCAINE 2% GEL ON PAIN INTENSITY DURING INTRAVENOUS CANNULATION AMONG PATIENTS AT SELECTED TERTIARY CARE HOSPITAL BELAGAVI”

2021 ◽  
pp. 22-23
Author(s):  
Mounesh Badiger ◽  
Honnagouda Patil
Keyword(s):  
Pain Intensity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Adult Patients ◽  
Control Group ◽  
Care Hospital ◽  
Intravenous Cannula ◽  
Cannulation Site ◽  
Post Test ◽  
Experimental Group

A true experimental, post test only control group design was used to nd out the effectiveness of Xylocaine 2% gel on pain intensity reduction during intravenous cannulation among the adult patients tertiary care hospital of Belagavi, Karnataka. Quantitative approach was used for the study. The study was done on 80 adult patients using standardized pain numerical scale. (Based on pilot study the prevalence rates in both group calculated p1=82% p2=100%, q1=18 q2=0, d=18% , Z= 1.96 (at 5% α error), Z= 0.842 (at 80% power) n=38 40). Simple random (lottery method) technique was used .in this study the patients, who have a patent intravenous cannula in place and who are unable perceive and responds for pain (unconscious patient). Demographical variables analyzed for the study Age, Gender, Education, Occupation, Previous experience, duration of pain during intravenous cannulation, site of cannulation and size of intravenous Cannula (Variables Independent variable: Xylocaine 2% gel. Dependent variable: Pain intensity experience during intravenous cannulation). Total 21 reviews were taken under the title of the above study (Indian- 03, International- 18). The conceptual framework used for this study is based on General Systems Theory introduced by Ludwig Von Bertalanffy in 1968. The obtained data was analyzed by using descriptive and inferential statistics. The mean of post test pain intensity during IV cannulation in experimental group was 1.93 and 4.30 in control group and SD of 0.60 in experimental group, 0.61 in control group. In this study 62.50% of participants have mild pain and 15% have moderate pain in experimental group as compared to 55% have severe pain followed by 37.50% have worst pain in control group. The difference is found to be statistically signicant

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