scholarly journals Eclampsia: Feto-Maternal Outcomes in A Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 54 (201) ◽  
pp. 24-28 ◽  
Author(s):  
Sita Ghimire
Keyword(s):  
Perinatal Death ◽  
Early Recognition ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Maternal Outcomes ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Common Causes

Introduction: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore we decided to study feto-maternal outcomes in our setting.Methods: A retrospective cross-sectional hospital based study carried out in Nobel Medical College, Biratnagar, from 17th June 2014 to 16th June 2015. Details and data obtained from Medical Record Section were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis.Results: Among 8,066 deliveries, 112 had eclampsia with incidence of 13.8/1000 deliveries. Majority (41%) were of <19 years of age. Above 90% were unbooked. Aoubt 63.4% were primiparas and 83% had antepartum eclampsia. Eclamptic fits were more common (41.6%) in 37-40 weeks period of gestation. Fits to delivery interval was more than six hours in 89.1% women and 69.3% women underwent caesarean delivery. About 18.9% women developed eclampsia related complications. Common causes of maternal deaths (5.36%) were pulmonary edema, aspiration pneumonia, cerebrovascular accidents and HELLP syndrome. Perinatal death was nine percent.Conclusions: Although the obstetric care facilities are improving with time, the feto-maternal outcomes are still poor in our country. Therefore early recognition and proper management are vital to tackle this challenge. Keywords: eclampsia; fetomaternal outcomes; retrospective analysis. | PubMed

scholarly journals Feto-Maternal outcomes in Intrahepatic Cholestasis in Pregnancy in a Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Sita Pokhrel Ghimire ◽  
Ashima Ghimire ◽  
Gauri Shankar Jha ◽  
Manisha Chhetry ◽  
Mahanand Kumar
Keyword(s):  
Intrahepatic Cholestasis ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Liver Function Tests ◽  
Maternal Outcomes ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Cholestasis Of Pregnancy

Background Intrahepatic cholestasis of pregnancy has poor feto-maternal outcomes. To date there has been sparse publications regarding impact of intrahepatic cholestasis in feto-maternal outcomes in our setting. Therefore, we aimed to study the feto-maternal outcome in patients with intrahepatic cholestasis of pregnancy.Material and Methods A hospital based prospective cross-sectional study carried out in department of Obstetrics and Gynecology of Nobel Medical College, Biratnagar, Nepal from 1st January 2014 to 30th December 2015 in women who presented with pruritus in third trimester of pregnancy and having deranged liver function tests. All the cases were followed from admission to discharge. Socio-demographic, clinico-laboratory profile and feto-maternal outcomes were recorded in a preformed structured proforma. Descriptive statistics was used to present the data.Results Among 6,780 women admitted for delivery, 80 had cholestasis of pregnancy with incidence of 1.15%. 83% were of 18-35 years and 65% were primigravida. Most distressing symptom was generalized pruritus (75.0 %). The cesarean delivery rate was 46.25% and labor induction rate was (47.5%). Fetal complications were seen in majority of cases that included meconium aspiration syndrome 26 (32.5%), intrapartum fetal distress 21 (26.25%) and requirement of: intensive care 38 (48.75%). There were 7 perinatal and 3 neonatal deaths.Conclusion Intrahepatic cholestasis of pregnancy seems fairly common among pregnant women. It may be responsible for a large number of perinatal and neonatal deaths especially after 36 weeks of gestation. A large prospective study is needed to address the problems in time.Journal of Nobel Medical College Volume 5, Number 1, Issue 8, January-July 2016, 20-25

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 Attitude towards mental illness among doctors and nurses in a tertiary care centre, Pondicherry, India

2017 ◽  
Vol 5 (7) ◽  
pp. 3059 ◽  
Author(s):  
V. Sujaritha ◽  
M. Partheeban ◽  
T. Thiviya ◽  
M. Sowmiya
Keyword(s):  
Mental Illness ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Educational Status ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Gender Influence ◽  
Positive Attitudes ◽  
Doctors And Nurses

Background: Stigma can prevent care and treatment of mentally ill. About 54% of diagnosable mental disorders are seen in primary care settings. There is a gross underestimation of psychiatric morbidity among patients by substantial proportion of non-psychiatric clinicians. Hence there is a need to assess the attitude towards mental illness among doctors and staff nurses. The objectives of the study were to assess the attitude towards mental illness among doctors and nurses, to compare the attitude between doctors and nurses, to find if there is any correlation between duration of training or posting and attitude, to find if educational status had any influence on attitude, to find if there is any gender influence on attitude. Methods: It is a cross sectional descriptive study conducted in a private medical college, Pondicherry among doctors and nurses who had completed their under graduation with a sample size of 221 (Doctors-120, Nurses-101). The instruments used were a semi-structured demographic profile and 34 items of OMICC (Opinion About Mental Illness in Chinese Community). The data was entered in Microsoft Excel 2013 analyzed using descriptive statistics, unpaired t-test, pearson’s correlation coefficient.Results: Only 25% of doctors and 4.9% of nurses positive attitude when overall score was considered. Doctors group had higher positive attitudes compared to nurses in domains separatism, stereotyping, benevolence and stigmatisation.Conclusions: There was no correlation between duration of psychiatry posting and attitude.

scholarly journals Study of cardiac manifestations in hypothyroid patients admitted in tertiary care centre

2021 ◽  
Vol 8 (12) ◽  
pp. 1852
Author(s):  
Parshv P. Shah ◽  
Harvy Parikh ◽  
Hemant Shah ◽  
Nilesh Doctor
Keyword(s):  
Early Recognition ◽  
Sinus Bradycardia ◽  
Tertiary Care ◽  
General Medicine ◽  
Thyroid Stimulating Hormone ◽  
Hormone Deficiency ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cardiac Manifestation ◽  
Cardiac Manifestations

Background: Hypothyroidism is the most common pathological hormone deficiency. To study various cardiac manifestations in overt and subclinical hypothyroidism.Methods: The cross-sectional analytic study is carried out on 60 patients of hypothyroid subjects in indoor facility of general medicine department in SMIMER hospital.Results: This study shows positive correlation between thyroid stimulating hormone (TSH) level, electrocardiogram (ECG) and echocardiographic findings. In this study, there is female predominance, ECG findings most commonly suggestive of sinus bradycardia and ECHO findings are most commonly suggestive of diastolic dysfunction with pericardial effusion.Conclusions: The early recognition and early initiation of treatment of hypothyroidism may helpful to lowering heart changes as hypothyroidism is reversible cause for cardiac manifestation.

scholarly journals Cross sectional study to assess the awareness of pharmacovigilance among post graduate residents of tertiary care medical college hospital of central India

2018 ◽  
Vol 7 (3) ◽  
pp. 386
Author(s):  
Pooja Solanki Mishra ◽  
Gopal Gudsurkar
Keyword(s):  
Graduate Student ◽  
Single Point ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Post Graduate ◽  
Global Database ◽  
Medical College ◽  
Post Graduate Student

Background: Pharmacovigilance knowledge and awareness in post graduate student doctors is key factor for proper implementation of PvPI. This study was planned to evaluate the knowledge &awareness of pharmacovigilance in post graduate students in tertiary care centre in Indore.Methods: It was a single point cross sectional questionnaire-based study conducted in a tertiary care Institute MGM Medical College & M.Y. Hospital in the state of Madhya Pradesh at Indore. It was conducted among post graduate student doctors from various clinical departments. Total of 150 questionnaires were distributed, 115 of them were returned back and were analysed.Results: Overall knowledge level was satisfactory. 91.30% knew about ADR while 95% were aware about PVPI. 13% knew about local AMC at Indore while only 4.34% knew global centre for Pharmacovigilance is at Sweden Uppsala. 86.95% thought Med watch as global database for ADR against only 13% knew its Vigibase. 96.50% thought ADR reporting is necessary. 97.40% thought it should be included in UG curriculum. 95.65% had not reported any ADR till date while 86.95% had not seen an ADR form.Conclusions: Post graduate doctors are the prime candidates to impart the importance of pharmacovigilance. The study strongly suggested that there was a great need to create awareness among the post graduate doctors to improve the reporting of ADRs.

scholarly journals Magnitude of hypothyroidism among patients of cholelithiasis in a tertiary care centre in rural West Bengal: a prospective study

2021 ◽  
Vol 8 (11) ◽  
pp. 3375
Author(s):  
Jaganmoy Maji ◽  
Debjyoti Mandal
Keyword(s):  
Stone Formation ◽  
Tertiary Care ◽  
Gall Stone ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Elder Patients ◽  
A Prospective Study

Background: Cholelithiasis is a common pathology of the gall bladder affecting about 10 to 15% of the adults in western countries and 2 to 29% in India. More than 80% of the patients with cholelithiasis are asymptomatic. Hypothyroidism may cause gall stone formation due to the hyperlipidemia, motility disorders affecting the bile duct and sphincter of Oddi.Methods: This was a descriptive cross-sectional study conducted at Department of Surgery, Bankura Sammilani Medical College and Hospital, Bankura from March 2019 to February 2020 for duration of one and half year. The sample size was 54 and consecutive non-probability sampling technique was used for the sampling. All the collected data were recorded in a pre-designed proforma and analyzed in MS excel.Results: Out of 54-patients with cholelithiasis, 28% patients were from the age group 45-54 years.40% patients were hypothyroid pre-dominantly females. Among 30-female patients 11 (26.82%) were hypothyroid and among 11-male patients 2 (15.38%) were hypothyroid. Hypothyroidism in male and female was statistically significant.Conclusions: This study was introduced to determine the relationship between hypothyroidism and cholelithiasis. It was concluded that hypothyroidism was more common in female, obese and elder patients. The gender distribution of the hypothyroidism in patients with cholelithiasis was statistically significant while all other variables were statistically not significant.  

scholarly journals Maternal and perinatal morbidity and mortality in COVID-19 positive obstetrics patients in tertiary care centre

2021 ◽  
Vol 10 (7) ◽  
pp. 2676
Author(s):  
Medha . ◽  
Neeta Chaudhary ◽  
Smita Tyagi ◽  
Kirtigiri G. Goswami
Keyword(s):  
Intensive Care ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Health Crisis ◽  
Medical College ◽  
Satisfactory Condition ◽  
Fluctuating Course

Background: COVID-19 disease had been declared as a public health crisis by WHO by the end of 2019. The effect of SARS-CoV-2 infection on pregnancy including symptoms, disease severity, risk of vertical transmission and perinatal and neonatal outcome have been the subject of research. Preliminary studies showed a fluctuating course of the disease ranging from asymptomatic or mild symptoms to even maternal death. However, recent evidences suggest that effect of COVID-19 infection during pregnancy may not lead to adverse maternal and neonatal outcome.Methods: In this cross sectional prospective observational study, we analysed 60 pregnant women infected with SARS- CoV-2 and their neonatal outcome, who tested positive for COVID-19 at district hospital, and were referred to Muzaffarnagar Medical College, were enrolled in this study.Results: The majority 96.7% (58) of these women were asymptomatic with cough being the most common symptom which was present in 3.3% (2) of the women. 24(75%) women developed pneumonitis radiologically, but they were asymptomatic, so intensive care was not required. Along with 76.08% (35) perinatal/neonatal outcomes were observed normal.Conclusions: In this study we observed that most of the women with COVID-19 were asymptomatic or with mild symptoms. Even though they were asymptomatic, most of the patients showed pneumonitis changes radiologically but still they didn’t require any intensive care, had good recovery postpartum and were discharged under satisfactory condition. The neonatal outcome was highly favourable.

scholarly journals Position of parotid papilla and commissure of lip in relation to maxillary occlusal plane among patients visiting a tertiary care centre of Nepal

2021 ◽  
Vol 4 (1) ◽  
pp. 1-6
Author(s):  
P Mehta ◽  
S Chhetri
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Occlusal Plane ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Exact Position ◽  
The Mean ◽  
Edentulous Patients

Introduction: The exact position of the Parotid papilla and commissure of the lip plays a crucial role in determining the maxillary occlusal plane which directly facilitates rehabilitating edentulous patients with a removable complete denture. Since the beginning, many authors have conducted different studies regarding its position but multiple variations in its location have been noted. Also, this type of study has not been conducted in the Nepalese population which drags the urge to determine the position of these soft-tissue landmarks in context to the Nepalese population. Objective: To determine the position of parotid papilla and commissure of lip in relation to the maxillary occlusal plane. Materials and Methods: A descriptive cross-sectional study was conducted in the 45 dentate subjects visiting Nobel medical college from November 2019 to April 2020. A vestibular impression was made, stone index fabricated and vernier caliper was used to locate position of parotid papilla & commissure of lip. All the data were collected and statistically analyzed. Results: The mean measurement of distances between maxillary occlusal plane and parotid papilla was 3.69 ± 1.19 mm and between maxillary occlusal plane and commissure of lip was 0.41 ± 0.83 mm respectively. Conclusion: This study showed that the position of the parotid papilla was superior to the position of the maxillary occlusal plane with a mean distance of 3.69mm. The commissure of lip was found to be at the level of maxillary occlusion plane in highest number of cases followed by a superior position with least at the inferior position with respect to the maxillary occlusal plane.

scholarly journals Awareness of contraception in post-partum women in a tertiary care centre

2017 ◽  
Vol 6 (9) ◽  
pp. 3850
Author(s):  
Rupali Atmaram Gaikwad ◽  
Shrinivas N. Gadappa ◽  
Sonali S. Deshpande
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Contraceptive Device ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Oral Contraceptive Pills ◽  
Medical College ◽  
Contraceptive Pills ◽  
Intrauterine Contraceptive

Background: In this modern or scientific era even though women are working equally or one step ahead of men, in family planning decision they are still lagging behind. Postpartum period is very crucial for a woman especially for many of those belonging to the villages as this may be the only time she comes in contact with a health personnel and in a mood to listen health advice. Keeping this in mind, this crucial period was considered as opportunity to test the issue of awareness regarding contraception.Methods: We conducted a cross-sectional study in the department of obstetrics and gynecology of Govt medical college and hospital, Aurangabad between August 2016 to December 2016. A total 720 post-partum women were interrogated and counselled regarding various methods of contraception.Results: Only 55.69% were aware about various methods of contraception. Awareness was maximum for Sterilisation (91%) followed by Intrauterine contraceptive device (81%) and Oral contraceptive pills (41%). Women knew about contraception from health care system (45%) and mass media (36%). After counselling 97% patients ready to use.Conclusions: There is lack of awareness regarding contraception. Contraceptive services are to be strengthened by intergrating with antenatal sevices.

scholarly journals A study to know clinical characteristics and outcome of obstetrics patients requiring ICU admission

2018 ◽  
Vol 7 (7) ◽  
pp. 2639
Author(s):  
Pratibha Garg ◽  
Urmila Tripathi
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Good Health ◽  
Health Care Team ◽  
Severe Anaemia ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Maternal Morbidity And Mortality

Background: Pregnancy poses unique consideration for critical care and it is imperative that obstetrician and other members of health care team have a working knowledge of these factors because these are women are usually young and in good health, their prognosis should be better than that of many other patients admitted to an intensive care.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology, Gaja Raja Medical College and associate Kamla raja Hospital, Gwalior in the ICU from Oct. 14 to Oct. 15.Results: 678 obstetric women were admitted into the ICU of Kamla Raja Hospital, over a period of 1 year study period. Maximum number of patients belong to age group 21-25 years (54.8%), 398 (58.7%) patients were uneducated, 343 (50.59%) came directly to Kamla Raja Hospital. 362 (53.39%) belongs to urban area. The mean length of stay in ICU was 3 days. Maximum number of patients were postpartum 580 (85.55%). According to mode of delivery maximum number of patients 348 (51.33%) underwent LSCS. Most common obstetric indication for admission in ICU was hypertensive disorder of pregnancy 472 (69.61%). Most common medical indication was severe anaemia 128 (18.87%). Various type intervention like pulse oxymetry, O2 inhalation, BT, nebulisation and ventilation were done in ICU according to patients need. 43 maternal death happened during the study period with most common cause was cardiorespiratory arrest 9 (1.32%) and pulmonary edema 8 (1.17%).Conclusions: Establishment of a dedicated obstetric ICU at tertiary care centre with knowledge familiarity, experience and expertise of an obstetrician and a special team would be best place to monitor and treat the critically ill obstetric patients which will reduce the maternal morbidity and mortality.

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