scholarly journals Analyzing uterine rupture: A study from tertiary care centre of western Nepal

2017 ◽  
Vol 4 (3) ◽  
pp. 95-99
Author(s):  
Junu Shrestha ◽  
Rami Shrestha
Keyword(s):  
Uterine Rupture ◽  
Tertiary Care ◽  
Operative Management ◽  
Demographic Variables ◽  
Bladder Injury ◽  
Tertiary Care Centre ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Uterine Scar ◽  
Scarred Uterus

Background: Rupture uterus is a serious obstetric complication which if diagnosed and managed early improves foetomaternal outcome.Objectives: To determine the frequency, causes, management aspects and foeto-maternal outcome of uterine rupture.Methods: This is a cross sectional observational study conducted in Department of Obstetrics and Gynaecology of Manipal Teaching Hospital from July 2012 to June 2015. All cases of rupture uterus, both complete as well as incomplete, diagnosed during surgery were included. Patient’s demographic variables, clinical presentation, risk factors for rupture were studied. Factors related to rupture like the type, nature and site of uterine rupture were noted. The operative management, maternal and neonatal outcome of the patients was reviewed. All the information was entered in the Microsoft Excel chart sheet. Data was analyzed using simple frequencies and percentages.Results: There were 22 cases of uterine rupture and 7987 deliveries during that period giving frequency of 2.8 rupture uterus in every 1000 deliveries. Uterine scar following previous cesarean section was the commonest (72.7%) cause for rupture uterus. Repair was the commonest (86.4%) surgical treatment done. There was no maternal mortality. Blood transfusion was needed two-third of the cases. Other complications were bladder injury (9.1%), paralytic ileus (9.1%), acute renal failure (4.5%) and pneumonia (4.5%). The perinatal mortality was 45.5%.Conclusion: Uterine rupture is a grave obstetric event with maternal and perinatal morbidity and commonly follows pregnancies with scarred uterus.

scholarly journals PRACTICES FOLLOWED DURING HOME QUARANTINE/ ISOLATION FOR COVID-19 PANDEMIC AMONG URBAN POPULATION OF ROHTAK, HARYANA

2020 ◽  
pp. 1-3
Author(s):  
B. M. Vashisht ◽  
Dhriti Bapna ◽  
Srishti Singh ◽  
Arup Saha ◽  
Manjeet Rathee ◽  
...  
Keyword(s):  
Urban Population ◽  
Tertiary Care ◽  
Structured Interview ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Microsoft Excel ◽  
Interview Schedule ◽  
Cross Sectional ◽  
Change Communication ◽  
Field Practice

Isolation is recommended for corona positive patients and their contacts are advised home quarantine. This study was planned to assess the practices followed during home quarantine/ isolation for COVID-19 pandemic among urban population in Rohtak, Haryana. A cross-sectional survey was conducted among 101 persons on home isolation or quarantine in urban field practice areas attached to the Department of Community Medicine of a tertiary care centre of Rohtak. A semi-structured interview schedule was used to obtain information from the participants through house to house visit. Data were analysed using Microsoft Excel version 2010 and Statistical Package for Social Sciences ver.24. 79.2% subjects on home quarantine/ isolation restricted their movement inside house. Face cover was used by 98% and correct hand washing technique was practised by 70.3% participants. Behaviour change communication activities need to be further strengthened to improve practices followed during home quarantine/ isolation.

scholarly journals Knowledge of nurses towards dengue fever in a tertiary care teaching hospital in Nepal

2014 ◽  
Vol 9 (1) ◽  
pp. 7-13
Author(s):  
S Valarmathi ◽  
S Parajulee
Keyword(s):  
Dengue Fever ◽  
Teaching Hospital ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Medical Sciences ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Important Health

Background: Nurses are important health care professionals and should have wide knowledge about common diseases especially infectious diseases like dengue. Dengue is associated with shock and can lead to death. Aim: To assess the knowledge of nurses regarding dengue fever and to study the association between the demographic variables. Setting and design: A cross sectional study was conducted at the College of Medical Sciences-Teaching Hospital, Nepal among the nurses during December, 2010. Study tool: Semi structured question was prepared to assess the knowledge of nurses in which there was objective question and Yes or No type questionnaire. Statistical analysis: The filled questionnaires were collected and data were entered in Microsoft excel sheet and analyzed as per study objectives. Descriptive statistic was used to calculate the median (IQR) and non parametric tests (Kruskal Wallis test and Mann Whitney test) to compare the total scores with demographic profile of the subjects. Results: Of the study members 89% were from Proficiency Certificate level (PCL) background and the mean (IQR) age of the respondents was 21 years (20-22.75). Overall score of the nurses was 11 (9-13) with a maximum possible score of 17. There were no association between the respondents knowledge scores with age (p=0.14); educational qualifications (p=0.86); duration of experience (p=0.59); ward (p=0.28). Conclusion: The study findings report a low knowledge among the nursing practitioners on dengue fever and its complications and their knowledge did not have any association with their demographic variables. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 7-13 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9667

scholarly journals Predictive factors of Uterine Rupture

2020 ◽  
pp. 01-05
Author(s):  
Aliou DIOUF ◽  
GUEYE M ◽  
NDIAYE GUEYE ◽  
THIAM O ◽  
MBAYE M ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Factors ◽  
Uterine Rupture ◽  
Demographic Characteristics ◽  
Microsoft Excel ◽  
Obstructed Labor ◽  
Uterine Scar ◽  
Scarred Uterus ◽  
Health Hospital ◽  
Ruptured Uterus

Objectives: To assess the frequency and predictive factors of uterine rupture on no-scar uterus and on scarred uterus in an intermediate level health hospital in Dakar. Method of study: This retrospective was carried out by the Philippe Maguilen Senghor Health Center in Yoff (Dakar) during the period from January 1, 2011 to December 31, 2017. It included all the women who gave birth there'' a single pregnancy after 22 weeks of amenorrhea with a longitudinal fetal presentation or admitted after childbirth. We had studied socio-demographic characteristics and risk factors for uterine rupture. The extracted data was analyzed first on Microsoft Excel 2016 and then on EPI info. Results: Over 7 years, 29,332 deliveries of single pregnancies were recorded in our structure with 54 uterine ruptures, and a frequency of 0.18%. Induction of labor was spontaneous in 47 of the patients who presented with uterine rupture; labor was artificially induced in only 7 patients, with frequencies of 0.17% and 0.36% of all uterine ruptures, respectively. Considering the risk factors of uterine rupture, 5 parameters were discriminating: multiparity (p<0.0001), transfer from another health facility for admission (p<0.0001), type of fetal presentation (p=0.0001), the presence of a uterine scar (p<0.0001) and the age class (p<0.0001). Conclusion: The rate of uterine rupture in our structure is certainly low but should call for more vigilance during labor with a focus on evacuated patients who have started their work in another structure, patients with a uterine scar and multiparous. Childbirth on a scar uterus is a reasonable option after eliminating a potential cause of obstructed labor. Keywords: Ruptured uterus; Scar uterus; Risk factors

scholarly journals Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009–2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

EXPERIENCE OF EVALUATION OF PATIENTS OF OBSTRUCTIVE JAUNDICE BY SONOGRAPHY AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY AT A TERTIARY CARE CENTRE IN EASTERN INDIA

2021 ◽  
pp. 61-64
Author(s):  
Santosh Kumar Prasad ◽  
Nupur Nupur ◽  
Akshit Pathak ◽  
Indra Shekhar Thakur ◽  
Vijay Shankar Prasad
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Hepatic Duct ◽  
Tertiary Care ◽  
Pancreatic Head ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Stricture Formation ◽  
Tertiary Care Centre ◽  
Left Hepatic Duct ◽  
Cross Sectional

INTRODUCTION: Jaundice means yellow due to the yellowish discolouration of skin, sclera, and mucous membrane seen in jaundice caused by bilirubin pigment. It is divided in to two forms obstructive(surgical) and non- obstructive (non-surgical). AIM AND OBJECTIVE: To evaluate patients of obstructive jaundice by sonography and magnetic resonance cholangiopancreatography and compare the reporting and ndings by both the modalities. MATERIALS AND METHODS: Cross sectional observational study done from November 2018 to October 2020 and consists of 32 patients who had clinical jaundice and consented to being subjected to both ultrasound and MRCP. OBSERVATIONS:Both USG and MRCP were able to detect extrahepatic CBD dilatation equally in 25 patients. In 5(15.6%) patients USG and MRI both demonstrated intrahepatic mass causing obstruction at the level of conuence of right and left hepatic duct or CHD. Ultrasonography was able to detect the intrinsic mass of the extrahepatic common bile duct in 2(6.2%) patients out of 32 patients in our study population. MRCP could detect the same in 6(18.7%) patients. In our study narrowing of CBD with stricture formation and upstream dilatation of biliary tree was identied in 10(31.2%) patients on MRCP. Ultrasound could diagnose the same in one patient. Both USG and MRCP were able to detect pancreatic head mass as well as pseudocyst. CONCLUSION: The accuracy of MRCP was found to be comparable to that of ERCP for diagnosis of etiology for obstructive jaundice. MRCP allows better lesion characterization and assessment. However, the patchy availability of MR machines become the main achilles heel for the surgeons as well as the radiologists. Hence the valuable role of the omnipresent ultrasonography become immense.

A Comparison of Falls and Dizziness Handicap by Vestibular Diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Vestibular Migraine ◽  
Cross Sectional ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Paroxysmal Positional Vertigo

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.

scholarly journals A Cross-Sectional Comparison of Drinking Patterns, Alcohol Use and Related Medical Morbidities in a Secondary Versus Tertiary Setting

2015 ◽  
Vol 11 (2) ◽  
pp. 152-157
Author(s):  
A Risal ◽  
H Tharoor
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Tertiary Care ◽  
Alcohol Use Disorders ◽  
Care Utilization ◽  
Drinking Patterns ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Patterns Of Drinking ◽  
Level Hospital

Background Alcohol Dependence exists in different spectrums at different settings and associated with various medical morbidities, disability and health care utilization costs. Objectives To study the drinking patterns, alcohol use disorders and alcohol related medical morbidities in patients diagnosed with Alcohol Dependence Syndrome (ADS) and attending out / in-patient psychiatry services at secondary and tertiary care centre. Methods A cross-sectional comparative study was done among the patients diagnosed with ADS attending psychiatry services at District hospital, Udupi and Kasturba Hospital, Manipal. Serial sampling was done. Patients having any other psychiatric illnesses were excluded. The two groups were compared in relation to socio-demographic variables, drinking related variables, patterns of drinking and alcohol related medical morbidities identified. Results Significant differences in some socio-demographic parameters among the patients from the two different treatment centers were found with secondary level hospital (N=50) having more illiterate, laborers and below the poverty line population in comparison to the tertiary level hospital (N=75). Maximum frequency of gastro-intestinal morbidities was seen in both the hospital population, irrespective of the patterns of drinking. Conclusion Alcohol use disorders and alcohol related medical morbidities show some variations in their presentations in the different treatment centers. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12492 Kathmandu University Medical Journal Vol.11(2) 2013: 152-157

scholarly journals Clinical and Etiological Profile of Mycotic Keratitis from a Tertiary Care Centre in South India

2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Corneal Ulcers ◽  
Prompt Treatment

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis

scholarly journals Awareness Regarding Implant Supported Dental Prosthesis; A Survey In Tertiary Care Set Up

2018 ◽  
Vol 08 (04) ◽  
pp. 250-253
Author(s):  
Anum Baqar ◽  
Saman Hakeem ◽  
Farnaz Ilyas ◽  
Abid Mohsin ◽  
Fatima Hassan ◽  
...  
Keyword(s):  
Dental Implant ◽  
Tertiary Care ◽  
Limiting Factor ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Dental Hospital ◽  
Set Up ◽  
Systemic Health ◽  
Implant Treatment

Objective: This research was aimed to assess the awareness and attitude regarding implant-retained prosthesis as the most advanced option for tooth replacement amongst residents of Karachi visiting tertiary care centre. Methodology: This cross-sectional survey was conducted in the department of Prosthodontics at Bahria University Dental Hospital, Karachi. Undertaking the demographic characteristics of patients, the objective was to determine the awareness and attitude toward implant supported prosthesis. Results: Amongst 380 responses retrieved, 9.8% of respondents were aware about the dental implant treatment. While correlating awareness with demographics features, awareness statistically increased with educational level (p= 0.00) and occupational category(p=0.01) of the participants. The friends and relative s(40.5%) were the main source of information regarding dental implant treatment modality. 54.1% were unwilling to undergo treatment with dental implant whereas high cost (55.2%)was the major limiting factor for implant treatment. 64.9% demanded dental insurance for getting the treatment. 45.9% had no knowledge regarding maintenance of implant supported prosthesis .73.0% had no idea regarding longevity of dental implant where as 86.5% were unaware of it’s impact on systemic health. Conclusion: The overall awareness regarding implant supported prosthesis was found to be minimal. This underlines the need of efforts and measures that should be made to raise the awareness and thus alter attitude towards dental implant therapy. Expensive rates (55.2%) was found to be the major limiting factor that should be relieved in the form of health insurance policies, especially in the developing countries like ours.

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