Frequency of maternal & perinatal mortality and maternal morbidity among obstetrical patients referred with history of unattended pregnancy.

Objective: To determine the frequency of fetomaternal morbidity and mortality among obstetric patients referred to tertiary care hospital with history of no antenatal visit. Study Design: Descriptive Case Series Study. Setting: Gambat Institute of Medical Sciences, Sindh Province. Period: June 2018 to December 2018. Material & Methods: About 175 pregnant females aged 18-35 years, having alive singleton pregnancy, gestational age >20-40 week without any history of obtaining antenatal care facility were included and followed-up till delivery and outcome were noted. Results: Mean age of females was 27.49 ± 4.46 years (18-35). Mean gestational age was 34.03 ± 4.07 weeks. About two third women (63%) were referred from rural areas. Maternal mortality rate was 12.6% while perinatal mortality was about 21.7%. Frequency of maternal morbidity of recorded as 34.9% case of hemorrhage, 36.6% case of anemia, 12.6% case of dystocia, 29.7% case of pre-eclampsia, 23.4% case of eclampsia & 19.4% case of sepsis. Maternal age was significant effect modifier for the frequency of pre-eclampsia, sepsis and maternal mortality (p<0.05). Conclusion: Maternal and perinatal morbidity & mortality are very high among women who have not attended the antenatal check-up. The major causes are haemorrhage, anaemia, pre-eclampsia/ eclampsia, dystocia and sepsis.

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Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.9-1.157 ◽

2022 ◽

Vol 9 (1) ◽

pp. 75-81

Author(s):

Muhammad Bilal ◽

Shafqat Ali Shah ◽

Marina Murad ◽

Saad Ali ◽

Ammad Ali ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Tertiary Care ◽

Case Series ◽

Female Gender ◽

Posterior Capsule Opacification ◽

Posterior Capsule ◽

Diabetic Patients ◽

Care Hospital ◽

Case Series Study

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.

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Steroid-induced Rosacea- A Study From a Tertiary Care Hospital of Eastern Nepal

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v19i1.35952 ◽

2021 ◽

Vol 19 (1) ◽

pp. 25-29

Author(s):

Manoj Chaudhary ◽

Sudha Agrawal

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Case Series ◽

Sun Exposure ◽

Care Hospital ◽

Facial Erythema ◽

Case Series Study ◽

The Face ◽

Triggering Factor ◽

Study Population

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour. Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face. Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017. Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%). Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.

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Tracheo-bronchial foreign bodies: our experience at a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20161848 ◽

2016 ◽

Author(s):

Shashidhar S. Suligavi ◽

Mallikarjun N. Patil ◽

S. S. Doddamani ◽

Chandrashekarayya S. Hiremath ◽

Afshan Fathima

Keyword(s):

Foreign Body ◽

Early Diagnosis ◽

Foreign Bodies ◽

Tertiary Care ◽

Case Series ◽

Team Work ◽

Care Hospital ◽

Retrospective Case ◽

Presenting Symptoms ◽

Case Series Study

Background:Tracheo- bronchial foreign bodies have always posed a challenge to the ENT surgeon as they present with varied symptomatology ranging from a simple cough and fever to more grave respiratory distress. It requires a strong suspicion, early diagnosis and timely intervention to reduce the overall morbidity and mortality .This study was undertaken to highlight our experiences in handling cases of tracheo- bronchial foreign bodies (FB) at our setup.Methods:It is a retrospective case series study conducted in S. Nijalingappa Medical College between January 2011 and January 2015. Results:Most commonly affected were children between 1year to 3years of age. Chronic cough and wheeze were the commonest presenting symptoms. Vegetative foreign body was found to be the commonest variety of foreign body. The mortality rate in our study was 4.7% (n=3).Conclusions:A good clinical acumen, team work, early diagnosis and timely intervention are all needed to reduce the overall mortality and morbidity associated with tracheo- bronchial foreign bodies.

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Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

Bangladesh Journal of Endosurgery ◽

10.3329/bje.v2i1.19588 ◽

2014 ◽

Vol 2 (1) ◽

pp. 9-14

Author(s):

Sheikh Shawkat Kamal

Keyword(s):

Middle Ear ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Retrospective Case ◽

Middle Ear Mucosa ◽

Case Series Study ◽

Temporal Bones ◽

Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27 ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

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Laparoscopic Surgical Management of Rectal Cancer at Tertiary Care Hospital

10.53350/pjmhs2115113285 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3285-3287

Author(s):

Zubair Yousfani ◽

Jabeen Atta ◽

Khenpal Das ◽

Madhu Bala ◽

Shagufta Magsi ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Hospital Stay ◽

Tertiary Care ◽

Case Series ◽

Operation Time ◽

Health Sciences ◽

Care Hospital ◽

Average Hospital ◽

Case Series Study

Objective: To evaluate the consequent outcomes in the patients with rectal cancer endured laparoscopic surgical excision at Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro, Hyderabad and to review their curative resection and recurrence rates, postoperative morbidities and complete survival. Methods: This prospective case series study was done at the Department of General Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan. All patients of 30-65 years ages with rectal cancer and underwent diagnostic laparoscopy either of gender were included. After removing the tumor, the specimen pinned out on a flat surface and placed in fixative solution to allow the orientation of the specimen and assessments of the exact margins. As the specimens had acceptable clear margins and limited invasion to the submucosa, no further surgical procedure was proceeded. Data was collected via study proforma. Results: A total of 40 patients were studied. Patients in the laparoscopic operation lost less blood with an amount of only 200mL during 190 minutes average operation time. The bowel functioning returned in 2 days averagely with 8 days average hospital stay. Conclusion: It is concluded that laparoscopic surgery for rectal cancer is an effective, safe and feasible approach in terms of less post-operative complications and recovery time as well as Hospital stay. Key words: Rectal Cancer, laparoscopic surgery

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Analysis of caesarean section rate in tertiary care hospital according to Robson`s 10 groups classification

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181023 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1380

Author(s):

Varija T. ◽

Veerendra Kumar C. M. ◽

Chandrasekhar Tarihalli

Keyword(s):

Caesarean Section ◽

Classification System ◽

Caesarean Section Rate ◽

Tertiary Care ◽

Case Series ◽

Breech Presentation ◽

Group Classification ◽

Care Hospital ◽

Case Series Study ◽

Group 5

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

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Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

Journal of Pregnancy ◽

10.1155/2014/431837 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Archana Kumari ◽

Avinash Chakrawarty ◽

Abha Singh ◽

Ritu Singh

Keyword(s):

Maternal Mortality ◽

Perinatal Mortality ◽

Tertiary Care ◽

Mode Of Delivery ◽

Neurological Involvement ◽

First Episode ◽

Care Hospital ◽

Spot Urine ◽

High Dependency ◽

Developed World

Objective. To investigate association between maternofoetal complications and the amount of proteinuria measured by spot urine protein creatinine ratio in patients with preeclampsia.Methods. 200 consecutive patients with preeclampsia were recruited in the study. The complications like first episode of severe hypertension, renal insufficiency, raised level of aspartate transaminase, signs of neurological involvement, thrombocytopenia, eclampsia, and need to shift in intensive care units were studied. The maternal outcome was studied in terms of type of labour, outcome of pregnancy, mode of delivery, indication of cesarean section, and maternal mortality. The foetal complications and outcome parameters were birth weight, Apgar score at the time of birth and at five minutes, need of high dependency unit care, and perinatal mortality.Result. The frequency of various maternal and foetal complications was between 14–53% and 22–92%, respectively. Maternal mortality was 3%, whereas perinatal mortality was 23%. Statistically significant association was found between the frequencies of various complications in mother and newborn and spot UPCR.Conclusion. The rate of various maternofoetal complications in preeclampsia is higher in developing countries than in developed world. Maternofoetal complications and outcome correlate with maternal spot UPCR.

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A clinical and demographic profile of the cleft lip and palate in Sub-Himalayan India: A hospital-based study

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.96602 ◽

2012 ◽

Vol 45 (01) ◽

pp. 115-120 ◽

Cited By ~ 12

Author(s):

Jyoti Dvivedi ◽

Sanjay Dvivedi

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Health Workers ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Low Socioeconomic ◽

The Status ◽

Baseline Information ◽

History Of

ABSTRACT Objectives: To study the cleft lip and cleft palate in the poverty stricken Sub-Himalayan Garhwal region of India, being a commonly seen congenital abnormality and scarcity of studies about the demography of cleft in this region. Design: A prospective cohort observational case series was performed on 4657 cleft patients at a Tertiary care Hospital in Dehradun, India, over a period of 5 years. Outcome measures: The authors investigated the differences between age and sex with cleft status and family history of clefts, birth order, religion, socioeconomic status, parent literacy, source of information for treatment, haematological investigations showing the status of infection and coagulation in such children and satisfaction after treatment. Results: Seventy-two percent parents of cleft lip patients were illiterate, and only 8% were graduates, the majority of patients were from the low socioeconomic class. The siblings of 1.1% of the cleft patients had similar deformity. Anemia was seen in 83.16% cases which was commonly microcytic hypochromic type and eosinophilia was seen in 25.50% of cases. In the coagulation profile, International Nationalized Ratio was found to be raised in 52.12%. Almost 95% of the families were fully satisfied by the treatment and results. Conclusion: This study will provide baseline information on the status of these less privileged cleft patients in this mountainous region for future reference to health workers.

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Frequency and Outcome of Hypoglycemia in Severely Malnourished Children at Tertiary Care Hospital Larkana

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i4431080 ◽

2021 ◽

pp. 51-56

Author(s):

. Rizwana ◽

. Bhagchand ◽

Gulab Rai ◽

Chetan Das ◽

Shanti Lal ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Series ◽

Serum Glucose ◽

Care Hospital ◽

Anthropometric Measures ◽

Malnourished Children ◽

Case Series Study ◽

Gender And Age ◽

Mid Upper Arm Circumference

Objective: To determine frequency and outcome of hypoglycemia in severely malnourished children at tertiary care Hospital Larkana. Methodology: This descriptive, case series study was carried out at the department of Pediatric Medicine Chandka Medical Hospital Larkana, during 6 months. Severely malnourished children of both gender and age between 6 months to 5 years were enrolled. Severity of malnutrition was evaluated as per standard anthropometric measures i.e. height, body weight, MUAC (mid upper arm circumference) by standard MUAC tape. Hypoglycemia was assessed by checking random blood sugar on glucometer. All the data was recorded via self-made proforma and analyzed by using SPSS version 20. Results: Mean age of the patients was 24.27±15.30 months. Mean MUAC was 9.39±1.56. There were 96 (52.20%) females and 88 (47.80%) males. Mean serum glucose level was found to be 86.02±21.58 mg/dL. There were 23(12.50%) patients with hypoglycemia and out of which 16 (69.60%) patients expired and 7 (30.40%) patients survived. Conclusion: Hypoglycemia was found to be 12.50% in severely malnourished children and it was significantly associated with adverse outcome.

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Study of antepartum hemorrhage and its maternal and perinatal outcome at a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212149 ◽

2021 ◽

Vol 10 (6) ◽

pp. 2210

Author(s):

Amruta R. Kulkarni ◽

Arti S. Shirsath

Keyword(s):

Maternal Mortality ◽

Perinatal Mortality ◽

Perinatal Outcome ◽

Placenta Previa ◽

Tertiary Care ◽

Care Hospital ◽

Mortality And Morbidity ◽

Antepartum Haemorrhage ◽

Medical College ◽

Abruptio Placenta

Background: Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Objective of this study is to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care hospital.Methods: A retrospective observational study was carried out in the department of obstetrics and gynecology, Smt. Kashibai Navale medical college and general hospital, Pune. Patient information was obtained from the delivery records of 2018, 2019 and 2020. Patients presenting after the gestational age of 28 weeks with antepartum haemorrhage were included in the study.Results: Out of 100 cases of APH, abruptio placenta contributes to 60%, placenta previa to 37% and 3 cases were due to unknown cause. Overall maternal mortality was 3% and perinatal mortality was 23% in abruptio placentas compared to 13% in cases with placenta previa. Main cause of perinatal mortality was prematurity69%.Conclusions: Antepartum haemorrhage is one of the leading cause of perinatal mortality and morbidity. These cases should be deliverd at a centre with transfusion facility, NICU facility and by the obstetrician skilled in controlling intraoperative haemorrhage by stepwise devascularising sutures. Timely decision of uterine tamponade can also save few ceaserean hysterectomies.

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