scholarly journals Use of antibiotics in newborns with maternal history of premature rupture of membrane

2017 ◽  
Vol 5 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Sunil Raja Manandhar ◽  
Dharma Sharna Manandhar

Background: The premature rupture of membrane is a major risk factor for the early onset sepsis in neonates. It increases the risk of serious neonatal infection to one percent, compared to 0.5% for women with intact membrane. There is a conventional practice of using antibiotics in most of the babies with maternal history of premature rupture of membrane >18 hours. It is noticed that all the babies may not need prophylactic antibiotics in these conditions and there should be judicial use of antibiotics in babies with maternal history of premature rupture of membrane.Objectives: To identify the risk factors for use of antibiotics in newborn babies born at Kathmandu Medical College Teaching Hospital with maternal history of premature rupture of membrane and to observe the outcome of the babies.Method: This is a prospective observational study done at Kathmandu Medical College Teaching Hospital. All newborns with maternal history of premature rupture of membrane for more than 18 hours were screened for neonatal sepsis and managed according to the treatment protocol. Ethical clearance was obtained and data were analyzed in statistical package for social science 16.Results: Among 160 cases included, 99 (62%) mothers received antibiotics for premature rupture of membrane and only 54 (35%) babies’ required antibiotics. Among them 30 babies required oral antibiotics, 20 babies required injectable antibiotics and four babies required both antibiotics(oral and injectable), which is statistically signifi cant (p value 0.03 ).Conclusion: This study has highlighted that every babies may not need antibiotics with maternal history of premature rupture of membrane. The use of antibiotics to mother for PROM before delivery has a signifi cant benefi ciary effect to babies reducing incidence of sepsis.Journal of Kathmandu Medical College, Vol. 5, No. 1, Issue 15, Jan.-Mar., 2016, Page: 3-10

2020 ◽  
Vol 9 (1) ◽  
pp. 25-30
Author(s):  
Dikchhya Sharma ◽  
Gunjan Prasai ◽  
Om Krishna Malla

Background: Pterygium induces a significant amount of astigmatism. Pterygium excision with conjunctival limbal autograft results in significant reduction in astigmatism by inducing a reversal of pterygium induced corneal flattening thereby improving the vision. Objectives: The aim of this study was to investigate the amount of corneal astigmatism in patients with pterygium before and one month (4 weeks) after surgery.  Methodology: The prospective observational study was conducted in 31 patients who underwent pterygium excision with limbal autograft in Kathmandu Medical College Teaching Hospital during the study period of 12 months duration. Patients with recurrent pterygium, pseudopterygium, history of ocular trauma, history of ocular surgery, corneal scarring were excluded from the study. After surgery, patients were followed for four weeks. Findings were recorded in the proforma and statistical analysis was done in SPSS version 19.   Results: Pterygium was seen in all age groups with majority being in the active age range of 41-50 yrs. Females were most commonly affected. Significant difference in corneal astigmatism was noted postoperatively with a p value being 0.01. Conclusion: The technique of pterygium excision with limbal conjunctival autograft not only reduces the chances of recurrence but also helps in reducing the induced corneal astigmatism which is responsible for decreased vision in patients with pterygium.


2015 ◽  
Vol 4 (3) ◽  
pp. 34-37 ◽  
Author(s):  
H K Subba ◽  
R Subba

Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and global health concern. COPD self care knowledge is a cornerstone for self-management of chronic illness. The objective of this study was to find out the level of knowledge on self care among COPD patients. A descriptive, cross sectional design and purposive sampling was applied in which 182 patients were interviewed by using semi-structure interviews schedule at Chitwan Medical College, Teaching Hospital, Bharatpur. Data was analyzed by using SPSS and descriptive and inferential test was applied. The study findings revealed that 36.8% of the respondents were between age group 61-70 years, 54.4% respondents were male, 59.9% were from Chitwan district, majority of the respondents (62.1%) were outpatient, 48.4% had a history of COPD more than 5 years, 83.2%were hospitalized 1-2 times in last year, 63.2% had no history of COPD in family members and all respondents got information from health personnel. Highest percentage (75) of mean score on smoking cessation and lowest (10) on weight monitoring. Most of all respondents (90.7%) had poor level of knowledge on self care of COPD. The respondents’ level of knowledge on self care is statistically significant with family history (p=0.048), educational status (p=0.000), and types of patient (p=0.017).So, there should be need of health education program for COPD patients about self care to improve knowledge. DOI: http://dx.doi.org/10.3126/jcmc.v4i3.11938Journal of Chitwan Medical College 2014; 4(3):34-37 


2017 ◽  
Vol 13 (1) ◽  
pp. 17-20
Author(s):  
Meraj Alam Ansari ◽  
Satindra Mohan Mishra ◽  
Binaya KC

Introduction: Rubber band ligation, an outpatient procedure for treatment of 2nd and 3rd degree hemorrhoids is an effective mode of management.Aims and objectives: To evaluate the effectiveness of rubber band ligation as an office procedure in the treatment of 2nd and 3rd degree hemorrhoids.Material and Methods: This is a cross sectional hospital based study of 30 cases that underwent rubber band ligation as an outpatient procedure for 2nd and 3rd degree hemorrhoids done in Nepalgunj Medical College Teaching Hospital from the period of August 2014 to June 2015. The patients were followed up for six months for the development of procedure related complications, relief of symptoms, and requirement of any further interventions. The total cost of treatment was calculated and the time off work was noted. Patients were requested to assess the forms of treatment as excellent, moderately successful or of little help based on their results post treatment. Statistical analysis using SPSS software (version 20) was done and p value less than 0.05 was taken as significant.Results: Post procedure complications were milder and self-limiting, with discomfort in 57.5% (2nd degree) and 60% (3rd degree), pain in 5% (2nd degree) 40% (3rd degree), bleeding in 22.5% (2nd degree) and 30% (3rd degree) of patients with absence of any major complications (sepsis or death). Majority (77.5% in 2nd degree, 70% in 3rd degree) of the patients significantly improved after initial treatment with band ligation. Some of the patients treated by band ligation required further intervention i.e. 16.66% in 2nd and 16.66% in 3rd degree as repeat ligation in the immediate post-op period and were managed subsequently. But none of them required any surgical procedures. Majority of the patients treated by band ligation were able to resume their normal work within three day i.e. 95% in 2nd and 90% in 3rd degree hemorrhoids. Most of the patients spent Rs 2000- 2500 (52.5% in 2nd and 40% in 3rd degree) which most was on routine checkups and follow-ups but it was very cheaper as compared to others modalities. Most of the patients (77.5% in 2nd and 70% in 3rd degree) treated by band ligation assessed the treatment as excellent.Conclusion: Rubber band ligation is a simple, safe and effective method for treating symptomatic second and third degree hemorrhoids as an outpatient procedure with significant improvement in quality of life. Immediate relief of symptoms can be obtained in the post-operative period and therefore be considered as the treatment of choice for second and third degree hemorrhoid. Though the complications are slightly higher and improvement in symptoms were delayed than in second degree but  still Rubber Band Ligation proved to be effective even in 3rd degree hemorrhoid.Journal of Nepalgunj Medical College Vol.13(1) 2015: 17-20


2021 ◽  
Vol 11 (2) ◽  
pp. 197-203
Author(s):  
Mangal Charan Murmu ◽  
Ratikanta Mahala ◽  
Jyoti Ranjan Champatiray ◽  
Madhusmita Pradhan

Premature rupture of membranes (PROM) is a syndrome characterized by rupture of the fetal membranes before labour. Acute chorioamnionitis complicates 0.5% - 10% of all pregnancies but the incidence may be as high as 3-25% in pregnancies complicated by PROM of more than 24 hours duration. Intrauterine infection specially chorioamnionitis is one of the most serious problems found by the practicing Obstetrician and subsequently by the Pediatrician. The incidence of neonatal infection for infants born to women with PROM range from 1 – 2.6%.   To know the incidence, clinical course, outcome of early onset sepsis following PROM more than 18 hours. Materials & Methods: This is a prospective study conducted from December 2018 to September 2020 in SCB Medical College and Hospital and SVPPGIP Cuttack. All neonates born to healthy mothers with PROM more than 18 hours during their hospital stay were studied. 53.3% of the cases had Premature rupture of membranes of 18-24 hours duration,38.3% cases had Premature rupture of membranes of 24 to 72 hour and 8.4 % cases had Premature rupture of membranes of more than 72 hr. RDS was the most common clinical manifestation (37.5%) followed by septicemia (10%), meningitis (1.7%) and pneumonia 1.7%. Most common organisms isolated in blood culture were Staphylococcus followed by Klebsiella, E. coli, Pseudomonas. The incidence of neonatal infection in neonates born to mothers with PROM was 10%. Premature rupture of membranes is responsible for increased perinatal morbidity among preterm neonates & directly proportional to duration of PROM. 


2019 ◽  
Vol 12 (1) ◽  
pp. 1-4
Author(s):  
Malati Tripathi ◽  
T Gurung ◽  
TM Ghale ◽  
B Gurung ◽  
C Pandit ◽  
...  

Background: Amniotic fluid index is one of the most commonly used methods of amniotic fluid volume assessment and is a predictor of adverse maternal and perinatal outcome. Objectives: To compare the maternal and perinatal outcome in women with singleton term pregnancies having amniotic fluid index (AFI) ≤5 cm to those having AFI ≥5 to 20 cm. Methods: This is a prospective, case-control study which was conducted at Gandaki Medical College Teaching Hospital over a period of one year from July 2017 to July 2018. It included 60 pregnant women at term pregnancy with amniotic fluid index ≤5 cm. The control group included 60 pregnant women at term pregnancy with amniotic fluid index ≥5 cm. The two groups were compared. Statistical analysis was done using the Chi-square test to calculate the P- value. Results: There was a significantly higher incidence of overall cesarean rates due to fetal distress, low birth weight babies and adverse neonatal outcome like 5 minute Apgar score ≤7, neonatal intensive care unit (NICU) admission rates, and meconium aspiration syndrome in the group with oligohydramnios as compared to the group with normal liquor volume. Conclusion: Oligohydramnios adversely affects the perinatal outcome. However a favorable outcome can be expected by good antenatal and intrapartum surveillance and neonatal care.


2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  


Author(s):  
Iqbal Ahmad ◽  
Ummer Farooq Raina ◽  
Muhammad Yousaf ◽  
Liaqat Jalal ◽  
Samia Saeed ◽  
...  

2021 ◽  
Vol 6 (1) ◽  
pp. 1285-1290
Author(s):  
Nilam Kumari Jha ◽  
Komal Kant Jha

Introduction: Anxiety and Depression is a common comorbidity in chronic obstructive pulmonary disease patients. Impaired lung function is a risk factor for depression In COPD patients, reduced recreational activities and social Isolation is a major risk factor resulting in anxiety and depression.  Objective: The objective of this study is to evaluate the prevalence of Anxiety and Depression among the COPD patients at Pulmonology unit of Nobel Medical College Teaching Hospital.  Methodology: A hospital based cross- sectional research design was used for the study. A total of 185 patients with previously diagnosed COPD. Data were collected by using a face to face interview technique in patients to evaluate anxiety and depression using Nepali version of Hospital Anxiety and Depression Scale questionnaire at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from May to August 2020. Data analysis were done by descriptive and inferential statistics.  Results: A total of 185 patients participated in the study, 157 patients (84.9%) had anxiety, 107 patients (57.8%) had depression and 102 patients (55.1%) had both anxiety and depression. There was statistically significant association of anxiety and depression in COPD patients with age, religion, occupation, smoking status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, type of family, domiciliary oxygen therapy.  Conclusion: The study concluded that anxiety and depression had been most prevalent in COPD patients. Therefore health personnel working in the Pulmonology unit should be aware the early assessment and treatment of anxiety and depression of chronic obstructive pulmonary diseases patients. 


Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
Smita Singh ◽  
Deependra Prasad Sarraf ◽  
Prabin Singh ◽  
Pragati Poudyel

Introduction: Pharmacovigilance helps in the detection and prevention of adverse effects of drugs. For the effectiveness of this program, health care professionals should report adverse drug reactions (ADRs) considering it as their moral and professional obligation. The objective of the study was to assess the knowledge, attitude, and practices (KAP) of the doctors towards ADRs and pharmacovigilance in  National Medical College Teaching Hospital (NMCTH), a tertiary care teaching hospital situated in the Narayani zone. Materials and Methods: A cross-sectional study was carried out using a self-administered questionnaire consisting of four parts; first part included a demographic profile of participants, the second part consisted of ten questions for the assessment of the knowledge about pharmacovigilance, third part comprised of six questions on attitude and fourth part consisted of five questions on practice. The results were depicted in the form of percentages for each KAPs questionnaire.   Results: The response rate of participants was 85.16%. Pharmacovigilance was correctly defined by 52%. Department of drug administration was responsible for monitoring ADRs in Nepal was correctly given by 80%. Only 8% had reported ADRs, although 62% had encountered an ADR in their clinical practice. Conclusion: The doctors at NMCTH had a poor KAP towards pharmacovigilance and educational intervention is needed for the proper functioning of this program.


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