scholarly journals Determinants of home delivery in a semi urban setting of Nepal

1970 ◽  
Vol 4 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Heera Tuladhar
Keyword(s):  
Antenatal Care ◽  
Family Member ◽  
Care Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
College Teaching ◽  
Home Delivery ◽  
Urban Setting ◽  
Care Hospital ◽  
At Home

Aim: To study the effect of various determinants of home delivery in Nepal.Methods: Prospective descriptive study among women who after being delivered at home were admitted inNepal Medical College Teaching Hospital (NMCTH), a tertiary care hospital situated at suburban area ofKathmanduResults: Of 114 women, majority were between the ages of 20-24 yrs. Most of the women were multipara(64%). Majority had no formal education accounting for 68.4 %. Lasheta (Lama, Sherpa , Tamang) was themost common ethnic group. Most (30.1%) of their spouses also were illiterate or had only primary leveleducation. Majority of the husbands of the respondents were laborers (63.2%). Regarding attendance ofantenatal care (ANC); at least 84 (73.7%) women had attended ANC once and half of the women hadattended 4 more visits. Home delivery was planned by 67 (58.8%) women; whereas only 47 (41.2%) hadchosen hospital delivery and delivered at home due to various reasons. Financial problem was the mostcommon reason followed by ignorance and transportation problem. Among all the women, only 5.3% wereattended to by a professionally trained provider (doctor, nurse, and midwife). A disturbingly high proportionof women (87.6%) were attended by an untrained family member, friend or neighbor, and 7% of womendelivered completely unattended. Women were brought to the hospital by family member 59.6% other thanhusband and 8.8% were accompanied by neighbors/friends. Most of these women were brought with retainedplacenta, primary post partum hemorrhage.Conclusion: In this study area, usage of the antenatal care was high, but the opportunity to deliver athospital was not fully utilized. This study has highlighted some of the factors affecting the choice of place ofdelivery among mothers in a semi urban settlement in Nepal namely mothers educational level, husband'seducation and occupation, financial constraints, lack of transportation and ignorance. Majority of thedeliveries took place at home and unsupervised by a skilled attendant thus aggravating the risk of the highperinatal and maternal morbidities and mortalities in the study area.Key words: Home delivery; determinants; antenatal care; delivery attendanceDOI: 10.3126/njog.v4i1.3329Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 30-37

scholarly journals Study of indications and post-operative complications of primary caesarean section in tertiary care hospital in Nepal

2018 ◽  
Vol 7 (3) ◽  
pp. 835 ◽  
Author(s):  
Sanyukta Rajbhanadary ◽  
Veena Rani Shrivastava
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
College Teaching ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Continuous Increase ◽  
Fetal Complications

Background: Caesarean section performed for appropriate obstetric or medical indications are life saving for both mother and new born. But its advantage does not justify its continuous increase as it is a major surgical procedure associated with maternal and fetal complications. The main objective of this study was to study the indications of primary caesarean section and its maternal and fetal complications in Nepal medical college teaching hospital (NMCTH).Methods: This is a hospital based cross sectional study carried out for a period of one year from 1st October 20113 to 30th September 2014 in department of obstetrics and gynecology in NMCTH Nepal. The study included 183 primary caesarean cases enrolled as per the inclusion criteria. The indications for caesarean section, associated maternal and fetal complications were noted.Results: The rate of caesarean section during the study period was 21.40%. The study included 183 patients who underwent primary caesarean section, 162 (88.5%) cases were emergency cases and 21 (11.5%). Cases were elective cases. The most common indications were fetal distress (n-74, 40.4%) followed by cephalo pelvic disproportion (n-27, 14.8%). The maternal complications seen were urinary tract infection (n-34, 68%), wound infection (n-12, 24%), post-partum hemorrhage (n-3, 6%). The common fetal complications noted were apgar score of less than 7 (n-7, 31.8%), transient tachypnea of newborn (n-6, 27.27%) and meconium aspiration syndrome (n-4, 18.18%).Conclusions: Emergency primary caesarean section was proportionally higher than elective caesarean section. It was also associated with more maternal and fetal complications.

scholarly journals Impact of Antenatal Care on Maternal and Perinatal utcome: A Study at Nepal Medical College Teaching Hospital

2012 ◽  
Vol 6 (2) ◽  
pp. 37-43 ◽  
Author(s):  
H Tuladhar ◽  
N Dhakal
Keyword(s):  
Cesarean Section ◽  
Antenatal Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
First Trimester ◽  
Elective Cesarean Section ◽  
Care Hospital ◽  
Medical College ◽  
Antenatal Visits

Aims: To identify the determinants of antenatal care (ANC) attendance and its impact on maternal / perinatal outcome. Methods: Prospective descriptive study of women delivered at Nepal Medical College Teaching Hospital (NMCTH), a 700 bedded tertiary care hospital situated at periphery of Kathmandu. Results: Among 322 women delivered during period of four months, majority (87%) reported of attending more than 4 antenatal visits, only 21 (6.5%) women had not attended ANC. The most preferred place of ANC was hospital (71.6%). Women with secondary education and above, business/service holders, 20-29 years age group, primigravida and Brahmin / Chhetri caste were more likely to attend ? 4 visits, while those living further than 6 km. from a health facility were less likely to attend. Financial problem (52.4%) followed by ignorance (28.6%) were the most commonly stated reasons for not attending ANC. Women attending more than 4 antenatal visits have more chance of full immunization with tetanus toxoid and iron supplementation. Most of the women started attending ANC from their second trimester (75.8%), only 21.9% had first ANC visit during first trimester. Overall Cesarean section rate was 17.4% and with increased rates in women who had attended ANC, because of the fact that all elective cesarean section were planned in these women only. Also, all inductions of labor (9.3%) were performed among them. Maternal complications like anemia and pregnancy induced hypertension occurred more commonly in women without ANC. The proportion of low birth weight and preterm babies was higher in women with inadequate or no ANC. Special care baby unit (SCBU) admission was also higher among them due to various reasons like neonatal sepsis, birth asphyxia, jaundice etc. While there were no neonatal deaths during the study period, 3 still births have occurred. Perinatal mortality rate was similar in no ANC and inadequate ANC groups; it was 16 times higher than that in the group with more than 4 visits. Maternal and perinatal outcomes were found to be better in women who attended regular ANC. Conclusions: Although attendance of ANC is quite encouraging, the proportion of women attending ANC from first trimester is low. The quality of antenatal care needs to be strengthened. The health system needs to ensure the availability of ANC in primary care level and to establish mobile clinics for those living far from the health facilities.NJOG 2011 Nov-Dec; 6 (2): 37-43 DOI: http://dx.doi.org/10.3126/njog.v6i2.6755

A Study on prescribing pattern of drugs in orthopaedic in-patient department at a tertiary care hospital in Guntur region

2020 ◽  
Vol 8 (2) ◽  
pp. 60-70
Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Delivery ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Prescribing Pattern ◽  
Prescribing Indicators ◽  
Bed Days

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.

Frequency of factors leading to acute renal failure in obstetric patients.

2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Placental Abruption ◽  
Post Partum ◽  
Common Factor ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.

A STUDY ON PREVALENCE OF POST-PARTUM DEPRESSION IN TERTIARY CARE HOSPITAL OF NORTH INDIA.

2021 ◽  
pp. 31-33
Author(s):  
Nidhi Johri ◽  
Priti Kumar
Keyword(s):  
Postpartum Depression ◽  
Tertiary Care Hospital ◽  
Post Partum ◽  
Tertiary Care ◽  
Depression Scale ◽  
North India ◽  
Postpartum Women ◽  
Care Hospital ◽  
Health Seeking ◽  
Prevalence Of Depression

Background: Depression is the most common complication postpartum affecting 10%–15% of women, contributing greatly to maternal mortality and morbidity, but the care availed is very low among the women who suffer. Aim and Objectives: The current study aimed to study the prevalence and associated risk factors of postpartum depression among recently delivered women in a tertiary care hospital of North India. Material and Methods: This was a hospital based cross-sectional study done between May 2019 and January 2020. All women in the study area who had a pregnancy outcome during the past 6 months and have completed 42 days since their last delivery were included in the study. The data on postpartum depression were collected using the Edinburgh Postnatal Depression Scale (EPDS). Results: There were 300 postpartum women in the study area who participated in the study. Mean age of the study participants was 24.5 years. The deliveries were Institutional in 98% of women. The prevalence of depression among the study women (an EPDS score of 10 and above) was 10%. Among women with depression, a history of depression before the last delivery was given by 40% of women. Only 7.5% of women had sought some form of health care for their problem. Conclusion: The study shows that the prevalence of depression among postpartum women is quite high and the health seeking for depression is very low. Health professionals and workers have to be trained to raise awareness, detect, and treat depression among postpartum women promptly

scholarly journals Pattern of Intra Ocular Foreign Bodies in a Tertiary Care Hospital of Punjab

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Usama Iqbal ◽  
Irfan Qayyum Malik ◽  
Zeeshan Hameed ◽  
Sadia Hameed
Keyword(s):  
Retinal Detachment ◽  
Foreign Bodies ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Hand Movement ◽  
College Teaching ◽  
Care Hospital ◽  
Phthisis Bulbi ◽  
Department Of Ophthalmology ◽  
Epidemiological Characteristics

Purpose:  To describe the epidemiological characteristics, management strategies and outcomes of intraocular foreign bodies (IOFB) presented in a tertiary care setup of Punjab. Study Design:  Descriptive retrospective study. Place and Duration:  Department of ophthalmology, Gujranwala medical college/teaching hospital, from January 2017 to December 2019. Methods:  A retrospective review, of all the patients who had IOFB removal, was performed. Information regarding the nature and circumstances of injury, types of IOFB, operative procedure performed and patient’s pre-operative and post-operative Best Corrected Visual Acuity (BCVA) were analyzed. Descriptive statistics were used for analysis of data. Results:  Record of 22 patients was retrieved. Out of which 18 (81.81%) were male and 4 (18.18%) were female. Mean age was 27.95 ± 9.325 years. Occupational trauma was the leading cause of injury (66.6%). Metallic objects were among the most common type of IOFB (66.6%) followed by glass, concrete stone (each 13.3%) and lead pencil (6.6%). Serious complications seen due to retained IOFB were phthisis bulbi (9.09%), retinal detachment (13.63%) and endophthalmitis (9.09%). On follow-up, 10 patients had BCVA less than hand movement (HM). 5 patients had BCVA of CF to 6/60, 3 patients had BCVA of 6/60-6/24 and 4 patients had better than 6/18. Conclusion:  Most common cause of IOFB was occupational trauma and young age group of working class was the most common population affected. Treatment delay and complications contributed to poor prognosis. Ocular safety measures during high-risk work can reduce the risk of trauma. Key Words:  Intra-ocular foreign Bodies, Retinal Detachment, Phthisis Bulbi.

scholarly journals Assessment of Factors Associated with Dropout for Pentavalent Vaccine in Tertiary Care Hospital of Kathmandu, Nepal

2020 ◽  
Vol 22 (3) ◽  
pp. 106-110
Author(s):  
Supri Raj Shrestha ◽  
B Shakya ◽  
R Oli
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Sampling Technique ◽  
Cost Effective ◽  
Dropout Rate ◽  
Care Hospital ◽  
Vaccine Preventable Diseases ◽  
Factors Associated ◽  
Pentavalent Vaccine

Immunization is one of the most cost-effective public health measures as it has helped in huge reduction of disease, disability and death from different infectious diseases in children by protecting them from vaccine preventable diseases. The current study aimed to study factors associated with dropout for pentavalent vaccine in tertiary care hospital of Kathmandu. A longitudinal observational study using purposive sampling technique was conducted among 196 infants. The information was obtained using self-constructed structured questionnaire from parents visiting Community Medicine OPD of Nepal Medical College Teaching Hospital. The information regarding socioeconomic characteristics of mother, gender of the infant, place of delivery of child, birth order and reasons for dropout of pentavalent third dose were taken. The dropout of third dose pentavalent vaccine was mainly seen in infant of parents living in rented house and according to gender wise, dropout was high among male infants. The different reasons for dropout of vaccine were busy parents, forgotten date, visit to other immunization centres and sick infants. Among these, the main reason for dropout of vaccine was due to infants getting sick during the time of immunization. The dropout rates between first and third dose of pentavalent vaccine were 26.3% and 30.4% respectively for two consecutive months and the overall dropout rate was 28.35%. Also, literacy level of the mother was directly associated with the immunization visit of the infant as, maximum number of infants of illiterate mother were absent for third dose of pentavalent vaccine as opposed to no absentee among master degree holding mothers. Thus, the present study provides valuable information regarding the factors associated with dropout for pentavalent vaccine.

scholarly journals A study on knowledge and practices of antenatal care among pregnant women attending antenatal clinic at a Tertiary Care Hospital of Pune, Maharashtra

2016 ◽  
Vol 9 (3) ◽  
pp. 354 ◽  
Author(s):  
BarunBhai Patel ◽  
Pranaya Gurmeet ◽  
DatttreyaRamkrishna Sinalkar ◽  
KapilH Pandya ◽  
Ajoy Mahen ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antenatal Clinic ◽  
Care Hospital

scholarly journals Prevalence of Pulmonary Tuberculosis among the suspected patients visiting tertiary care hospital in Birgunj, Nepal

2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha
Keyword(s):  
Pulmonary Tuberculosis ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
National Medical College ◽  
Medical College ◽  
National Medical

Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52

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