scholarly journals Intrauterine fetal death: Five years’ experience in a secondary care hospital.

2021 ◽  
Vol 28 (08) ◽  
pp. 1076-1082
Author(s):  
Erum Saleem Khan ◽  
◽  
Mahwash Jamil ◽  
Reeta Chanderparkash ◽  
Sheikh Irfan ◽  
...  
Keyword(s):  
Fetal Death ◽  
Tertiary Care ◽  
Gynecologic Cancer ◽  
Care Facility ◽  
Intrauterine Fetal Death ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Fetal Demise ◽  
Intrauterine Fetal Demise ◽  
Tertiary Care Facility

Objectives: The objectives of this study were to estimate the prevalence, preoperative, and operative risk factors associated with the higher risk of SSI in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Study Design: Retrospective Study. Setting: Obstetrics and Gynecology Department, Agha Khan Hospital for Women Garden Karachi, Pakistan. Period: Jan 2012 to Dec 2016. Material & Methods: Retrospective review of medical records of patients over a period of five years from Jan 2012 to Dec 2016 was done. Results: The study consisted of 56 cases of intrauterine fetal demise out of 4813 number of deliveries which occurred during the study duration. Overall estimated rate of intrauterine fetal demise was 11.6 %( 56/4813). Approximately 33.9% of cases did not have a clear cause of fetal death identified and hence were un-explained. In 56 cases, 28.6% had some form of congenital abnormality identified on ultrasound, 7.1% (n=4) had anemia, 23.2% (n=13) IUGR, 5.4% (n=3) placental abruption and 1.8% (n=1) of gestational diabetes and around 83.9% (n=47) had normal vaginal delivery and 8 were delivered by LSCS and only 1 patient had instrumental delivery. Fetal characteristics identified 50% (n=28) were males and 50% (n=28) were females. 4 fetuses were born with tight cord around their neck 58.1% were macerated stillbirths (n=25) while 32.6% were fresh stillbirth. Conclusion: Antepartum intrauterine fetal death or stillbirths in the third trimester, affect the entire family. We conclude from our study that quality antenatal care with health education and timely interventions can reduce the number of intrauterine fetal deaths thus reducing the psychological sequelae.

Assessing Acute St-Elevation Myocardial Infarction With Prognostic Significance Of The Hyponatramia

2020 ◽  
Vol 11 (3) ◽  
pp. 3251-3260
Author(s):  
Makrand B Mane
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Care Facility ◽  
Early Death ◽  
Public Health Issue ◽  
Care Hospital ◽  
Tertiary Care Facility ◽  
Significant Public Health

Acute Myocardial Infarction (AMI) has become a significant public health issue in developed and developing nations, following extensive diagnostic and management research over recent decades. The study intended to research the prognostic values of inexplicable Hyponatremia in patients with severe STelevation of myocardial infarction, in 100 consecutive patients admitted to Tertiary care hospital. In the analysis, identified patients on admission were diagnosed with or produced Hyponatremia within 72 hours—a lower ejection fraction than those with usual amounts of sodium. The research aimed to evaluate the prognosis significance of Hyponatremia for the estimation of early death in acute ST-elevated myocardial infarction. One hundred straight patients admitted in the Coronary Centre Tertiary Care Facility with severe STelevated myocardial infarction were studied. The data of the study on various risk factors in association with the development of Hyponatremia like as age, sex, use of tobacco, diabetes, hypertension, ejection fraction etc. were analyzed. Thus, the researchers reported that in patients diagnosed with severe ST section escalation, Hyponatremia showed the initial emergence of hyponatremia myocardial infarctions. This condition correlates with the severity of LV dysfunction (in term of LVEF) and can be considered as an individual early death indicator as well as a prediction exacerbates with hyponatremia frequency.

scholarly journals Indian diabetes risk profile of employees in a tertiary care facility in north Maharashtra: a cross sectional study

2021 ◽  
Vol 8 (10) ◽  
pp. 4944
Author(s):  
Shyam V. Ashtekar ◽  
Aryaman Singh ◽  
Manasi S. Padhyegurjar ◽  
Sidrah M. Shaikh ◽  
Abhimanyu R. Kapse ◽  
...  
Keyword(s):  
Physical Activity ◽  
Tertiary Care ◽  
Care Facility ◽  
Cross Sectional Study ◽  
Diabetes Risk ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Waist Size ◽  
Tertiary Care Facility

Background: The rising prevalence of type 2 diabetes (T2D) in India calls for screening of at-risk adults. Objectives were to assess IDRS (Indian diabetes risk score) of T2D in staff in tertiary care hospital, and to assess covariates random blood sugar (RBS), BMI, skinfold thickness (SFT), pre-existing T2D in the employees.Methods: In this cross sectional study, IDRS was used to assess all staff in a tertiary care institute. Anthropometric measurements, BP and RBS were done. Information on parental T2D, cereal intake and weekly physical activity (PA) was obtained in interview.Results: 370 subjects (F-117, M-273) with mean age 30.81 (7.99), BMI 22.89 (14.13) years were screened. Subjects in moderate and sedentary work were 185 each, 15% women and 39% men had higher waist size. Total 5.4% subjects had T2D including known diabetics. RBS in women and men was 113.1 (27.87), 114.7 (27.66), with IDRS score high in 29 (7.84%) and moderate in 144 (38.92%). Parental T2D was present in 19.5% subjects. IDRS risk was strongly associated with type of work (Chi-square 79.0283, df=4, p=0.00). Multiple logistic regression for IDRS risk outcome showed association of age (OR 1.4), BMI (OR1.3), parental T2D (OR 9.6) with highly significant p values. Multiple linear regression for RBS outcome was associated with age (OR 1.3) and BMI (OR 1.4) but the results were statistically not significant.Conclusions: Pooled IDRS risk was present in 47% subjects despite younger age of study population. Improvements in physical activity and reduction in waist size is the need of the hour.

Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country

2017 ◽  
Vol 5 (1) ◽  
pp. 23-27
Author(s):  
Erum S Khan ◽  
Sheikh Irfan ◽  
Natasha Khalid
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Developing Country ◽  
Gynecologic Oncology ◽  
Tertiary Care ◽  
Gynecologic Cancer ◽  
Care Facility ◽  
Site Infection ◽  
Tertiary Care Facility

ABSTRACT Introduction Surgical site infections (SSIs) are among the most common complications in surgical patients and have serious consequences for outcomes and costs. There is a dearth of information on risk factors for developing SSI in patients undergoing gynecologic cancer surgery, and this has not been studied using national data. Objectives The objectives of this study were to estimate the prevalence, preoperative and operative risk factors associated with the higher risk of SSIs in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Setting Department of Obstetrics and Gynaecology, Aga Khan University Hospitals, Karachi, Sindh, Pakistan. Materials and methods Retrospective record review of gynecologic oncology patients admitted for surgery from January 2015 to December 2015 was performed. Results A total of 100 patients met the inclusion criteria. Of these, 15 were identified with SSIs, which were all found to be of the superficial type. Approximately, 44, 40, and 7% were diagnosed with endometrial, ovarian, and cervical cancers respectively. The mean time from surgery to developing SSI was 12.9 days. Among endometrial cancer, 22.7% (10/44) had SSI compared with 7.5% (3/40) for ovarian cancer and 14.2% (1/7) for cervical cancer. The significant predictors of SSI were body mass index ≥35 (p-value <0.004), endometrial cancer diagnosis, the American Society of Anesthesiologists class more than 3, modified surgical complexity scoring system 3 to 4, and blood sugar levels more than 180 mg/dL within 48 hours after surgery in known diabetics. Conclusion About 15% of patients undergoing laparotomy for gynecologic malignancy developed SSIs. In this study, we identified several risk factors for developing SSI among gynecologic cancer patients. These findings may contribute toward identification of patients at risk for SSIs, and the development of strategies to reduce SSI rate and potentially reduce the cost of care in gynecologic cancer surgery. How to cite this article Khan ES, Irfan S, Khalid N. Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country. J South Asian Feder Menopause Soc 2017;5(1):23-27.

scholarly journals A prospective study of intrauterine death cases at a tertiary care hospital

2021 ◽  
Vol 10 (2) ◽  
pp. 638
Author(s):  
Nabila N. Tai ◽  
Rinku Mulchandani ◽  
Dipti A. Modi ◽  
Bijal Rami
Keyword(s):  
Prospective Study ◽  
Fetal Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Intrauterine Fetal Death ◽  
Intrauterine Death ◽  
Care Hospital ◽  
Risk Pregnancy ◽  
A Prospective Study ◽  
Death Cases

Background: Intrauterine fetal death is defined as foetus with no signs of life in utero after 20 weeks of gestations. Stillbirth is a useful index to measure the values of antenatal and intra-natal care. Intrauterine fetal death is due to various causes whether it be maternal causes, fetal causes or placental causes.Methods: It was a prospective study, conducted at SSG hospital, Vadodara over a period of 1 year from January 2019 to December 2019. All pregnant women coming to labour room with intrauterine fetal death with gestation age more than 28 weeks were included in study. It included complaints on admission, obstetric profile, mode of delivery, fetal outcomes, placental examination, condition of cord and investigation reports.Results: During the study period of one year, a total of 462 intrauterine fetal deaths were reported amongst 7295 deliveries conducted during the study period. Incidence rate calculated was 63/1000 births. Many of the intrauterine fetal death cases were associated with pregnancy induced hypertension and antepartum hemorrhage. Out of all intrauterine death cases, 410 cases delivered vaginally. Congenital anomalies were also found to be associated with intrauterine death cases.Conclusions: High risk pregnancy cases should be identified during routine antenatal check-ups so that intrauterine fetal death can be prevented. The mode of antepartum and intrapartum surveillance for fetal wellbeing should be advanced to prevent fetal demise.

scholarly journals (A22) Impact of Karachi Terrorist Bombing on an Emergency Department of a Tertiary Care Hospital

2011 ◽  
Vol 26 (S1) ◽  
pp. s6-s7
Author(s):  
H. Waseem ◽  
S. Shahbaz ◽  
J. Razzak
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Wound Care ◽  
Tertiary Care ◽  
Care Facility ◽  
Care Hospital ◽  
Disaster Plan ◽  
Tertiary Care Facility ◽  
Number Of Patients ◽  
The Government

ObjectivesThe objective of this study was to collect epidemiological injury data on patients presenting to the emergency department of a tertiary care hospital after the bombing on 29 December 2009.MethodsThis was a retrospective review of the medical records of the victims that were brought to a tertiary care hospital. Bombing victims were described as requiring acute care due to the direct effect of the bombing.ResultsThe results are derived from a sample size of 198 bomb blast victims, most of which were first transported to government hospitals by private cars rather than ambulances. After the government announced free treatment, there was a wave of patients, among which, most were stable and already had received some form of treatment. Approximately 5–6 patients who had life-threatening injuries were brought directly to the tertiary care facility and needed surgical intervention. The lack of security in the emergency department could have lead to another terrorist activity. There were no procedures done in the field as there is lack of emergency medical services training in Pakistan, but in the hospital most of the interventions included intravenous (IV) lines, wound care, and laceration repair. The most common treatments included the administration of IV fluids, antibiotics, and analgesia. Radiographs of specific sites and trauma series were used to rule out bone injuries. There was lack of documentation in most of the medical charts.ConclusionsThe emergency department was overwhelmed with the number of patients that it received. Therefore, an updated disaster plan and regular disaster drills are required. Rapid and accurate triage could minimize mortality among bombing survivors significantly. The majority of patients were discharged home.

scholarly journals Study on Etiology and Maternal Complications of Intrauterine Fetal Death

2019 ◽  
Vol 18 (1) ◽  
pp. 23-26
Author(s):  
Adiba Malik ◽  
Tahera Begum ◽  
Serajun Noor
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Fetal Death ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Intrauterine Fetal Death ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Antenatal Visits

Background : Management of pregnancy with good fetal and maternal outcome is a challenge to the obstetrician which can be achieved by screening the risk factors of Intra Uterine Fetal Death (IUFD) and thereby prevent, control and treat them by quality preconceptional and antenatal care. Materials and methods: This cross-sectional study, done in a tertiary care hospital during a period of two years where 100 pregnant women with history of intrauterine fetal death were included after informed written consent. Intrauterine fetal death was confirmed by Ultrasonogram. Different risk factors and maternal complications were observed. Then data was analyzed with the help of SPSS-20. Results: Among 100 women, maximum patients were aggregated between age group 26-35 years (45%) and next to which was 16-25 years (35%) primipara was 32% and multipara was 31%. Regarding Antenatal care (ANC) 32% patients attended two antenatal visits and 28 % patients had no antenatal visits and 18% patients completed > 5 visits. Regarding causes of IUFD, 34% due to hypertension in pregnancy, 14% mother was severely anemic, 13% mother had Diabetes Mellitus (DM) abruptio placenta was found in 15% mother, maternal gastroenteritis 05%, maternal fever 09%, cord accident 3% and in 19% cases no causes were identified. Regarding maternal complications, blood transfusion needed in 28% patients, PPH occurred in 12% patients, Sepsis 08%, caesarean section needed in 07 % cases, ARF 4%, DIC in 03% cases and maternal mortality 01%. Mean ± SD of total hospital stay was 4 ± 1.5 days. Conclusion: There are different risk factors of IUFD which if identified earlier,then by treating the correctable etiologies, recurrence of IUFD and its related maternal complications can be prevented or reduced. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 23-26

scholarly journals Placental pathology in intrauterine fetal death

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2376-2380
Author(s):  
Nanda J. Patil ◽  
Jyoti S. Tele ◽  
Rohit S. Kadam ◽  
Pawar S. J ◽  
Sujata M. Kumbar
Keyword(s):  
Fetal Death ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Mirror Image ◽  
Intrauterine Fetal Death ◽  
Care Hospital ◽  
Placental Pathology ◽  
Cross Sectional ◽  
Present Cross Sectional Study ◽  
To Come

Placenta is the most accessible and readily evaluable specimen which is mirror image of pregnancy. The objective here is to study the histomorphological changes in placenta in cases of intrauterine fetal deaths and to study correlation of placental findings with causes of fetal death which is significant to understand. The present cross sectional study was carried out in Department of Pathology of a tertiary care hospital from June 2015 to May 2017. Study of Placental Pathology in Intrauterine Fetal Death cases comprised of 99 placentas. The present study was undertaken to study the placental pathology in cases of intrauterine fetal death. IUFD was found to be more common in primigravida 50/99 (50.50%) mothers. Placental study gives useful morphological information regarding the abnormality of pregnancy. Gross and microscopic examination of the placenta plays an important role in identifying the underlying causes of fetal death and helps prevent further recurrence by making appropriate interventions during the next pregnancy. Study of placental pathology gives clues to events occurring throughout gestation and can potentially help to answer, questions concerning pregnancy management and risk assessment of future pregnancies. It will help the researchers who are doing the research in the field of placental pathology in the days to come.

scholarly journals Analysis of factors responsible for intrauterine fetal death in rural pregnant women at tertiary care centre of Northern India

2017 ◽  
Vol 6 (9) ◽  
pp. 4071 ◽  
Author(s):  
Shaveta Garg ◽  
Naina Kumar
Keyword(s):  
Fetal Death ◽  
Tertiary Care ◽  
Intrauterine Fetal Death ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Northern India ◽  
Number Of Patients ◽  
Tragic Event ◽  
Abruptio Placenta ◽  
One Year

Background: Intrauterine fetal death (IUFD) is a tragic event for both the parents and obstetrician. Objectives of current study were to study the underlying etiology of Intra Uterine Fetal Death (IUFD) that can be helpful in formulating the preventive measures.Methods: This study was conducted over a period of one year from April 2016 till March 2017 at a tertiary rural care hospital. All patients with diagnosed IUFD at >24 weeks of gestation were included in the study.Results: Total eighty patients were admitted with diagnosis of intrauterine fetal death. Among these majority 58 (72.5%) were multigravida and only 22 (27.5%) were primigravida. Maximum number of patients, 61 (72.5%) were between age group of 20-30 years. Maximum number of IUFD were reported between 36-40 weeks of gestation (36.25%). Most of fetal deaths were due to preventable conditions like hypertensive disorders of pregnancy (28.75%), severe anemia (15%), abruptio placenta (11.25%), and rupture uterus (10%). Out of these patients 68 (85%) delivered vaginally and 7 patients were delivered by LSCS.Conclusions: The present study emphasizes the role of health education, regular antenatal checkups, early detection of complications and hospital delivery to reduce the overall preventable IUFD.

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