scholarly journals MATERNAL SEPSIS;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Maternal Morbidity And Mortality ◽  
Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

scholarly journals A study of maternal morbidity associated with caesarean delivery in tertiary care hospital

2017 ◽  
Vol 4 (5) ◽  
pp. 1542 ◽  
Author(s):  
Dasari Gayathry ◽  
Visweswara Rao Guthi ◽  
Sameer Bele ◽  
Achanta Vivekannada
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maternal Morbidity And Mortality ◽  
Indications And Complications ◽  
Structured Questionnaire

Background: Cesarean section is one of the most commonly performed surgical procedures in the world. Several studies have demonstrated that c/s poses a greater risk of maternal morbidity and mortality compared to vaginal delivery. Therefore, it is important to assess the morbidities associated with a c/s. Methods: A hospital based, cross sectional study was conducted among 240 women during the period of March-May 2014. A semi-structured questionnaire was used to evaluate the socio-demographic characteristics, obstetrical characteristics, indications and complications following c/s. Results: A total of 150 (62.5%) respondents underwent emergency c/s whereas 90 (37.5%) were having elective c/s. The most common indication for cesarean delivery was a previous c/s observed in 70 (29.2%). No postpartum morbidity was observed in 152 (63.3%) of the respondents, whereas 88 (36.7%) had reported some or other kinds of morbidities. Among the various maternal morbidities, postpartum anemia was the most commonly observed morbidity in 22 (9.2%) of the respondents, followed by postpartum hemorrhage by 10 (4.2%) and wound infection was observed in 15 (6.25%). Conclusions: High maternal morbidity following c/s was observed in studied sample as more than one third of the women had shown some or other kinds of morbidities. Efforts should be made to evaluate the reasons for increasing c/s rate and to reduce the incidence of c/s by careful antenatal and intranatal management. 

scholarly journals A rare case of severe pulmonary hypertension in pregnancy

2020 ◽  
Vol 9 (11) ◽  
pp. 4707
Author(s):  
Ramna Banerjee ◽  
Farheen Rahman
Keyword(s):  
Pulmonary Hypertension ◽  
Maternal Morbidity ◽  
Rare Case ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Severe Pulmonary Hypertension ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

Heart diseases in pregnancy have always been a source of major concern for both the patients as well as the caregivers because of the high risk of maternal morbidity and mortality and the need for specialist care by a multidisciplinary team preferably in a tertiary care hospital. Amongst the whole gamut of heart diseases, pulmonary hypertension is associated with high maternal morbidity and mortality (in the order of 20% in some studies) and hence is considered a contraindication for pregnancy. We report a rare case of a lady at 36 weeks gestation in her second pregnancy, with a previous caesarean section, who was incidentally diagnosed with severe pulmonary hypertension (PAP-110 mmHg) during her antenatal check-up in the third trimester of pregnancy and survived without any major complications after being promptly referred to and treated in a multispecialty hospital. Her previous pregnancy was absolutely uneventful and even in this pregnancy she had very mild symptoms as compared to the severity of the disease found on further investigation.

scholarly journals Frequency of Different Ocular Conditions Leading to Ocular Morbidity in Pediatric Age Group at Dow University Hospital

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Madiha Jawaid ◽  
Mazhar-ul- Hassan ◽  
Saba Al-Khairy ◽  
Farnaz Siddiqui ◽  
Asad Azeem
Keyword(s):  
Visual Acuity ◽  
Positive Impact ◽  
Tertiary Care ◽  
Age Groups ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Ocular Abnormality ◽  
Ocular Morbidity

Purpose:  To determine the frequency of different ocular conditions leading to ocular morbidity in a tertiary care hospital. Study Design:  Descriptive cross sectional study. Place and Duration of Study:  Study was done in Dow University of medical sciences, from May 2018 to October 2018. Methods:  A total of 278 patients presenting in the eye out-patient department were included. Patients with unaided visual acuity of 6/6 in both eye and no ocular abnormality were excluded from the study. Children with congenital syndromes like Down’s syndrome, etc. leading to eye diseases were also excluded. All children underwent complete ocular examination. Data was analyzed by using SPSS version 22. Frequency and percentages were computed for gender and different ocular diseases e.g., myopia, hypermetropia, strabismus, Vernal Kerato-conjunctivitis, astigmatism, red eye, subconjunctival hemorrhage etc. Post-stratification chi-square test was applied with p-value ? 0.05. Results:  Out of 278 participants of the study, there were 154 (55.4%) males and 124 (44.6%) females. Average age of the patients was 11.15 ± 3.44 years. Myopia and red eyes were the major causes of pediatric ocular morbidity i.e. 33.81% and 26.6% respectively. Comparison between two age groups showed that Myopia was higher in children with 11 to 15 years. Myopia and astigmatism were more common in females while sub-conjunctival hemorrhage was more in males. Conclusion:  Refractive errors are the commonest cause of childhood visual impairment in our setup. Correcting these preventable diseases can have a positive impact on the performance of children at school. Key Words:  Visual acuity, Pediatric, Myopia, Hypermetropia, Kerato-conjunctivitis.

scholarly journals Determinants of Contraceptive Use Among Female Undergraduates in Edox State

2020 ◽  
Author(s):  
Tijani Idris Ahmad Oseni ◽  
Mojeed O Momoh ◽  
Christopher Chidozie Affusim
Keyword(s):  
Safety Profile ◽  
Maternal Morbidity ◽  
Contraceptive Use ◽  
Male Partner ◽  
Morbidity And Mortality ◽  
P Value ◽  
Modern Contraceptive ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Maternal Morbidity And Mortality

Abstract Background: Nigeria has one of the highest maternal morbidity and mortality worldwide. Use of modern contraceptive has been shown to significantly reduce maternal morbidity and mortality. However, contraceptive use is still low among young women in Nigeria. This study was to determine the prevalence and determinants of contraceptive use among female undergraduates in Edo State.Methods: The study was a cross sectional study. 360 female undergraduates attending Irrua Specialist Teaching Hospital who met the eligibility criteria were consecutively recruited and questionnaire administered to them. The results were analysed using epi info 3.5.4 statistical software and significance level was set at p value less than 0.05.Results: The prevalence of contraceptive use among female undergraduates was found to be 28% despite 100% knowledge of contraception. Reasons for non-usage included fear of future infertility, refusal by male partner, fear of safety profile of the methods and lack of interest. Determinants of contraceptive use among the study population were older age (p = 0.02), being single (p = 0.04) and high socioeconomic status (p < 0.001).Conclusion: Contraceptive use is low among female undergraduates despite adequate knowledge due to fear of adverse effects and non-cooperation by male partner.Implication for Action: There is need for greater advocacy and education on the safety profile of modern contraception by policy makers, as well as educating men on the importance and benefits of contraception as their cooperation is key to increased usage.

scholarly journals Morbidly Adherent Placenta: Management options

2021 ◽  
Vol 31 (01) ◽  
pp. 3-7
Author(s):  
Abida Sajid ◽  
Aqsam Sajid Aqsam Sajid ◽  
Arham Sajid Arham Sajid ◽  
Maham Abid Maham Abid
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Case Series ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Management Options ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Vaginal Deliveries ◽  
Maternal Morbidity And Mortality

Background Placenta previa with placenta accreta spectrum is one of the most feared complications responsible for increased maternal morbidity and mortality. This study aims to reduce maternal morbidity and mortality by detecting risk factors, performing relevant investigations, and deciding appropriate management options. Methods: The study design is a descriptive case series, carried out on 72 patients of MAP of a tertiary care hospital, in a 6-years duration from January 2014 to December 2019. Patients of OPD and the emergency department were diagnosed for MAP by using grayscale ultrasounds, color Doppler USG's (in most cases), and MRI's (in only a few cases). Different management options were studied and maternal morbidities were observed.  In the majority of cases, patients had operative deliveries with planned/ emergency hysterectomies, except for some having conservative surgery. Results: In the period of 6 years, the total number of deliveries was 35940. Out of these, 22140 were spontaneous vaginal deliveries and 13800 were C-sections.  The incidence of MAP was 1 per 499 normal deliveries and 1 per 192 in C-sections. The criteria for MAP was fulfilled by 72 patients. MAP diagnosed in the antenatal period was 43% while 57% were diagnosed in an emergency. The majority of patients had a history of C-sections and many underwent emergency obstetric hysterectomies. Blood transfusions were given to all patients in our study. Only 4(5.5%) patients died in our study. Conclusion:      Antenatal diagnosis of morbidly adherent placenta, followed by a well-planned surgical management, avoidance of placental separation and early caesarean hysterectomy ultimately result in a better maternal outcome. Keywords: Morbidly Adherent Placenta, Maternal Morbidity, Massive Obstetric Hemorrhage, Obstetric Hysterectomy.  

scholarly journals Frequency and determinants of postpartum depression.

2020 ◽  
Vol 27 (05) ◽  
pp. 1017-1021
Author(s):  
Muhammad Umar Ghafoor ◽  
Rabia Arshed Usmani ◽  
Zaidan Idrees Choudhary ◽  
Shahbaz Ahmad ◽  
Aftab Nazir ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Postnatal Depression ◽  
Medical Information ◽  
Tertiary Care ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional

Objectives: This study was designed to evaluate the frequency of postpartum depression in new mothers at a tertiary care hospital in Faisalabad and identify the factors associated with the condition. Study Design: Cross-sectional study. Setting: Obstetrics and Gynecology Department of Independent University Hospital, Faisalabad. Period: Over a period of three months from February 2018 to May 2018. Material & Methods: Included 213 subjects selected through nonprobability purposive sampling patients who had given birth in the last six months were included in the study. The Punjabi version of Edinburgh Postnatal Depression Scale was used to assess for depression. Socio-demographic and medical information was collected on a pre-designed proforma. Data was analyzed using SPSS version 23. Chi square test was applied to ascertain association. Results: Out of the total 213 participants, 33.8% (n=72) of the study sample were suffering from postnatal depression. The socio-demographic profile of the depressed patients showed that most of them were uneducated (84.72%), housewives (77.78%) living with extended families (68.06%). The difference in the number of depressed women among extended and nuclear families was found to be statistically significant (p-value of 0.004). The study also showed that women suffering from postpartum depression were less likely to breastfeed their babies (p-value 0.046). Conclusion: Postpartum depression was identified in more than one thirds of the females included in this study. This high number should raise an alarm for all health professionals. Detection through mandatory screening and early intervention can prevent the adverse consequences this disorder carries for the mother and the child.

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

2020 ◽  
Keyword(s):  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Traumatic Head Injury ◽  
Keywords Epilepsy ◽  
College Hospital ◽  
Cross Sectional

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

COMPARATIVE EVALUATION OF SPIROMETRY PARAMETERS IN HEALTHY YOUNG AND ELDERLY ADULTS POPULATION IN PUNJAB, INDIA

2021 ◽  
pp. 1-3
Author(s):  
Ajay Pal Singh ◽  
Kailash Meena ◽  
Surinder Pal Singh ◽  
Avnish Kumar ◽  
Ashish Shukla ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Tertiary Care ◽  
P Value ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Age Group ◽  
Elderly Adults ◽  
Elderly Age ◽  
Cross Sectional ◽  
Age Related

INTRODUCTION: Spirometry is a vital tool for the assessment of pulmonary function status. Spirometry can be used to demonstrate the age-related decline in pulmonary function. The spirometry values can be used as reference values for a particular age group. The aims of our study was to compare spirometry values between the young and elderly groups and evaluate age-related changes in both groups. MATERIAL AND METHODS: A cross-sectional study was conducted on 600 adults, which divided into two healthy groups: one was of young adults (18-35 years), and other was of elderly adults (>60 years) of 300 persons, each taken over a period of one year, in the Department of pulmonary medicine, a tertiary care hospital, Punjab. We conducted spirometry in both age group. Spirometry values were measured FVC, FEV1, FVC/FEV1, PEFR, and FEF25- 75 % of each groups.The subjects were selected based on random sampling RESULT: Spirometry values compared between young and elderly adults. Mean BMI in young and elderly groups was 25.09±2.87 and 25.82±2.45, respectively. Spirometry values in FVC , FEV1, FEV1/FVC , PEFR and FEF25-75% in young was 4.31± 0.18 , 3.84,± 0.88± 0.02, 9.87± 0.38 and 3.75 ±0.26 and elderly age group 3.01±, 2.60 ±0.85± 0.02, 7.70± 0.30 and 2.82 ± 0.26. On statistical analysis, p value <0.001 in all spirometry parameters. CONCLUSION: The study shows that there was a decline in spirometry parameters of healthy adults with the increase in age. This decline was signicant in all spirometric parameters (FVC, FEV1, FEV1/FVC, PEFR, FEF25–75%) measured in the present study

Increased frequency of fibromyalgia among patients with chronic pain presenting to internal medicine clinics of a tertiary care hospital: a cross sectional study

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Sana Javed ◽  
Muhammad Zaid ◽  
Sumera Imran ◽  
Ayesha Hai ◽  
Muhammad Junaid Patel
Keyword(s):  
Internal Medicine ◽  
Tertiary Care ◽  
Chronic Fatigue ◽  
Cross Sectional Study ◽  
National Language ◽  
P Value ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio

Objective: To estimate the frequency of patients with fibromyalgia (by using the 2010 Modified Criteria for Fibromyalgia by American College of Rheumatology ( ACR ) presenting to Internal Medicine clinics  Methods: A cross-sectional study conducted in the department of Internal Medicine, the Indus Hospital, khi, Pakistan between December 2016 and March 2018. Patients who visited internal medicine clinics, met the selection criteria, were included in the study. After taking informed consent patients were assessed for fibromyalgia according to the new 2010 Fibromyalgia Diagnostic criteria questionnaire. The patients were asked the questions in the national language, Urdu. Data analyzed using SPSS version 21. P value of < 0.05 was considered significant. Results: Of the 267 patients presenting to the internal medicine clinics and consenting for participating in the study 149 (55.80%) met at least one of the 2010 Fibromyalgia Criteria. The prevalence of fibromyalgia as estimated in this study was 56% with no difference in gender. Mean age of patients with fibromyalgia was 42.3 ± 14.6 and patients without fibromyalgia was 38.9 ± 13.7 which was statistically significant (p-value = 0.05, 10% level of significance). Of the 267 patient 197 (73.8%) were female and 70 (26.2%) were males, a male to female ratio of 1:2.81.  Conclusion: All patients with generalized pain should be evaluated for fibromyalgia and a diagnosis made to reduce the cost of further referrals and investigations and delay in the management of this debilitating disorder. Keywords: Fibromyalgia, Chronic fatigue, Generalized Pain  

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