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

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

scholarly journals Maternal and Fetal Outcome in Elective versus Emergency Cesarean Section

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Anupama Suwal ◽  
Veena R Shrivastava ◽  
Amrita Giri
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
College Teaching ◽  
Fetal Outcome ◽  
Elective Cesarean Section ◽  
Emergency Cesarean Section ◽  
Medical College ◽  
Emergency Cesarean ◽  
Significant Difference ◽  
Elective Cesarean

Introduction: The complications of cesarean section are seen more commonly in emergency than in elective cases. The aim of this study was to find out the incidence of cesarean section in Nepal Medical College Teaching Hospital and to compare the maternal and fetal outcome in elective and emergency cesarean section. Methods: A prospective study of all the cases undergoing cesarean section in Nepal Medical College Teaching Hospital was carried out during the period of six months from Asar 2069 to Mangsir 2069. Results: The incidence of cesarean section was 254 (22.30%) out of which emergency cesarean section accounted for 167 (65.7%) and elective cesarean section for 87 (34.3%). The usual indications of emergency cesarean section were fetal distress, previous cesarean section in labour, non progress of labour and prolonged second stage of labour. The usual indications of elective cesarean section were previous cesarean section, breech, cephalopelvic disproportion and cesarean section on demand. There was found to be no significant difference in age, period of gestation, blood loss and blood transfusion in emergency vs. elective cesarean section. There was significant difference seen in the length of hospital stay, fever, urinary tract infection, wound infection and low APGAR in five minutes indicating that these were more common in emergency cesarean section. Significant difference was also seen in the incidence of postpartum haemorrhage indicating that it was seen more in elective cesarean section. Conclusions: The incidence of cesarean section in Nepal Medical College Teaching Hospital is high and the overall complication rate is higher in emergency cesarean section than in elective cesarean section.Keywords: cesarean section; fetal and maternal outcome.

scholarly journals Prevalence and Antibiotic Sensitivity Pattern of Methicillin- Resistant- Staphylococcus aureus in Kathmandu Medical College -Teaching Hospital

2013 ◽  
Vol 34 (1) ◽  
pp. 13-17 ◽  
Author(s):  
S Pandey ◽  
MS Raza ◽  
CP Bhatta
Keyword(s):  
Staphylococcus Aureus ◽  
Teaching Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
College Teaching ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Medical College ◽  
Sensitivity Pattern

Introduction: Staphylococcus aureus is found to be a major source of community as well as hospital acquired infection. Staphylococcal isolates from tertiary care hospital are found to be resistant to commonly used antimicrobial agents. Methicillin resistant S. aureus (MRSA) with intrinsically developed antimicrobial resistance has been associated with an increase in morbidity and mortality of the patients in the hospital. This study was undertaken to know the antibiotic sensitivity pattern of staphylococcal isolates with special reference to Methicillin resistant S. aureus. Methods: Clinical specimens received from July 2009 to July 2010 in Kathmandu Medical college-Teaching Hospital were processed and all S. aureus isolates were included in the study. The isolates were identified by standard laboratory procedure. The antibiotic susceptibility pattern of all staphylococcal strain was determined by modified Kirby Bauer antibiotic sensitivity method. Results: Of 111 S .aureus isolates 29(26.12%) were identified to be MRSA. The rate of multi drug resistance was 75.86% for MRSA and 6.09% for MSSA. All the staphylococcal isolates were resistant to penicillin. However, all strains were sensitive to vancomycin. Conclusions: This study showed a high prevalence of MRSA in tertiary care hospital of Kathmandu valley. Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is mandatory to reduce MRSA prevalence in hospital and its spread to community as well. Present study conclusively shows that vancomycin remains the first choice of treatment for MRSA infection. To preserve its value, use of vancomycin should be limited to those cases where there are clearly needed. DOI: http://dx.doi.org/10.3126/joim.v34i1.9117 Journal of Institute of Medicine, April, 2012; 34:1 13-17

scholarly journals Attitude of Interns towards Family Medicine as a Career in a Tertiary Care Hospital

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Anu Kushwaha ◽  
Anuj Raj Kadel
Keyword(s):  
Family Medicine ◽  
Social Services ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Time Period

Introduction: Family medicine is a relatively overlooked specialty in Nepalese medical education. It is unclear how many interns are actually interested in Family medicine as a career and how many non-medical individuals are aware of its existence. The aim of this study is to assess information, expectation and perception among interns regarding family medicine and its choice as a career. Methods: This is a descriptive-cross sectional study carried out in Kathmandu Medical College Teaching Hospital from July 2018 to December 2018. Whole sampling was done. All interns of Kathmandu Medical College Teaching Hospital posted in different departments during the time period was the inclusion criteria. Chronic absentees was the exclusion criteria. Factor like age, sex, their residency of choice, and whether they consider family medicine as a potential career were considered. Data was entered in with Statistical Package for Social Services version 16 and necessary calculations were done. Results: Thirty three interns preferred internal medicine as their career of choice, 20 preferred surgery while only three preferred in family medicine. Eighty eight interns, including the three who had family medicine as their career of choice, said that they could consider family medicine as a potential career. Eighty eight out of the 100 interns in the study mentioned that their family had knowledge that a specialty called family medicine existed. Conclusions: Despite being the career of choice of only a few, majority considered family medicine as a potential career for them. And the knowledge about existence of family medicine was high among families of interns.

scholarly journals Analysis of transfusion of blood and blood products and their utilization pattern at department of obstetrics of tertiary care hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 261
Author(s):  
Dipti C. Vasava ◽  
Rajal V. Thaker ◽  
Aditi A. Tyagi ◽  
Foram P. Patel
Keyword(s):  
Antenatal Care ◽  
Institutional Delivery ◽  
Tertiary Care ◽  
First Trimester ◽  
Obstetric Complications ◽  
Care Hospital ◽  
Blood Products ◽  
Utilization Pattern ◽  
Obstetric Haemorrhage ◽  
Antenatal Visits

Background: In developing countries, nutritional anaemia and obstetric complications are leading causes of transfusion of blood and blood products. The study was aimed to analyse utilization pattern and to identify the indications of transfusion of blood and blood products in obstetrics and to study outcome and management of pregnancy in patients who required blood and/or blood products.Methods: This retrospective study was carried out at department of obstetrics of tertiary care teaching hospital from September 2018 to November 2018 and data was collected from all patients who had received transfusion of blood and/or blood products for any obstetric cause.Results: A total of 164(6.8%) patients received blood and blood products transfusion. Department of obstetrics utilized maximum units of blood and FFP whereas PRC utilization was second highest. There were 62(37.8%) of patients who had not taken any antenatal care, whereas 64(39.0%) patients had less than 4 antenatal visits. Three most common indications for transfusion of blood and blood products were 63.4% in nutritional anaemia, 17.1% in obstetric haemorrhage and 11.6% in first trimester complications.Conclusions: Three most common indications for transfusion were nutritional anaemia, obstetric haemorrhage and first trimester complications. Majority of patients had inadequate or no antenatal care. Early and regular antenatal care, early diagnosis and management of high-risk pregnancies and obstetric complications, institutional delivery can reduce the rate of transfusion of blood and blood products.

Knowledge, Attitude and Practices of Pharmacovigilance among Doctors at a Tertiary Care Teaching Hospital Birgunj, Nepal

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
Smita Singh ◽  
Deependra Prasad Sarraf ◽  
Prabin Singh ◽  
Pragati Poudyel
Keyword(s):  
Teaching Hospital ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Medical College ◽  
National Medical

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.

scholarly journals Study in the Quality of Clinical Documentation Practice in Chitwan Medical College Teaching Hospital, Nepal

2016 ◽  
Vol 12 (2) ◽  
pp. 11-16
Author(s):  
Upendra Pandit
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Final Diagnosis ◽  
Pooled Analysis ◽  
Medical Documentation ◽  
Medical College ◽  
Patient Consent ◽  
One Year

Background: Primary documentation of a patient is crucial for making effective healthcare decision and improvements in the quality of care. The objective of this study was to assess the quality of current documentation practice in tertiary care hospitals. Materials and methods: This was an assessment of medical documentation practice of one year from the period of January 2010 to December 2010 in Chitwan Medical College, Teaching Hospital. Total 184 patients' discharge files were enrolled and reviewed. Documentation was reviewed in its quality such as completeness, Coherent, consistency and Legibility.Results: In overall pooled analysis, High omission rate was observed in final diagnosis, results (cure, improved, referral and death), hospital stay, and final case summary. Although, satisfactory performance was observed in complete set of forms (72.2%); Patient consent for treatment &release authorization forms (78.2%) and treatment chart (60.8%), the overall pooled performance in ten components showed50% performance gap. Study demonstrated that documentation and its legibility, coherent and consistency in all departments needs substantial improvements in the institution.JNGMC Vol. 12 No. 2 December 2014, Page: 11-16

Knowledge and Attitude Regarding Cervical Cancer Screening in Women attending Obstetrics and Gynaecological Opd at Birat Medical College Teaching Hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 1055-1059
Author(s):  
Raj Deb Mahato ◽  
Amit Deo ◽  
Hanoon Pokharel
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Tertiary Care ◽  
Negative Attitude ◽  
College Teaching ◽  
Care Hospital ◽  
Medical College ◽  
The Mean ◽  
Knowledge And Attitude

Introduction: Cervical cancer is the most common Gynaecological cancer in Nepal which is preventable if appropriate screening and prevention measures are employed. Considerable reduction in cervical cancer incidence and cervical cancer related deaths can be achieved by effective screening. However, lack of knowledge and awareness can result in underutilization of the preventive measures.  Objectives: The objective of this study was to assess the knowledge and attitude regarding cervical cancer screening in women visiting Obstetrics and Gynaecology OPD at tertiary care Hospital in Eastern Nepal.  Methodology: A cross-sectional questionnaire-based study was conducted in Obstetrics and Gynaecology outpatient department of Birat Medical College Teaching Hospital from 1 January 2019 to 31 December 2019. Women were enrolled in the study by convenient sampling methods. Structured questionnaire was used to collect the data. The collected data was entered in Microsoft excel and analyzed by using SPSS version 22.  Results: Among 374 participants, the mean age was 31.13 years. More than three fourth (89.6%) of participants were literate. Regarding occupation, 89.8% of participants were housewives, and 82.9 % of participants were married. As per the findings, only 43.27 % of participants i.e. less than the mean, had adequate knowledge of cervical cancer and its screening. 65.50 % of participants had a negative attitude towards cervical cancer screening. Literate participants had good knowledge and positive attitude regarding cervical cancer screening than illiterate participants (P value less than 0.05).  Conclusion Considerable proportions of participants had inadequate knowledge and negative attitude regarding cervical cancer screening in Gynaecological patients visiting tertiary care Hospital in Eastern Nepal.

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 Prevalence and Outcome of Cesarean Section at Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal

2017 ◽  
Vol 9 (2) ◽  
pp. 1-6
Author(s):  
Rubina Tamrakar Gurung ◽  
G Gurung ◽  
R Shrestha ◽  
T Gurung ◽  
P Sharma
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
College Teaching ◽  
Fetal Distress ◽  
Safe Motherhood ◽  
Research Centre ◽  
Cesarean Sections ◽  
Old Patients ◽  
Medical College ◽  
Failed Induction

Introduction: Gandaki Medical College Teaching Hospital is providing specialized obstetrician and gynecologist services since last one decade.Objectives: This study was conducted to know the prevalence and outcome of cesarean section at Gandaki Medical College Teaching Hospital and Research Centre during 2013 – 2015 A.D. (2070 – 2072 B.S.).Methods: It was a retrospective study of women undergoing cesarean section from 2013 to 2015 A.D. (2070 – 2072 B.S.).Results: During the period of three years 2013 – 2015 A.D. (2070 –2072 B.S.) otal deliveries were 2627. Among total deliveries cesarean section was performed in 1084 patients (41.26%). In 1084 patients 803 (74%) cesarean sections were performed as an emergency and 281(26%) were elective. In this study 15 to more than 35 years old patients were enrolled. Among cesarean sections done, 52% were primigravida, 46% were para and 2% were grandmulti. The indications for cesarean section were CPD (28%), fetal distress (25%), previous cesarean (14%), mal presentation (7%), premature rupture of membrane (5%), pre-eclampsia (6%), failed induction (5%), bad obstetric history (2%), antepartum hemorrhage (1%), and twins (1%).Conclusion: This study at Gandaki Medical College Teaching Hospital and Research Centre provided the prevalence, outcome and different indications of cesarean section which is life saving for both mother and newborn. And also the study can be useful to the hospital to improve facilities for safe motherhood and safety of newborn.Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December  2016, Page: 1-6

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