scholarly journals Advance Age Pregnancy in a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Vibha Mahato ◽  
Pravin Shrestha ◽  
Smita Shrestha

Introduction: Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. Methods: A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. Conclusions: From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.

2021 ◽  
Vol 59 (235) ◽  
Author(s):  
Anupama Thapa Basnet ◽  
Suraj Singh ◽  
Bijay Thapa ◽  
Anuj Kayastha

Introduction: Acute appendicitis is the most common reason for abdominal surgery in children. Though appendectomy considered the gold standard there are a lot of complications related to it. Conservative management of acute appendicitis is not new to medical science. In pandemic like COVID-19 when all the health systems were about to shut-down because of lack of manpower and resources, we started a trial of non-operative management. The main aim of this study is to find out the management of acute appendicitis during COVID-19. Methods: This was a descriptive cross-sectional study conducted in a tertiary care centre. Data collection was done from the record section which included the patients diagnosed with acute appendicitis from February 2020 to July 2020 after obtaining ethical clearance from Institutional Review Committee. Cases of appendicular lump, appendicular abscess, appendicular perforations have been excluded. Data was collected and entry was done in Statistical Package for the Social Science software version 20, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The conservative management of acute appendicitis was done in 44 cases (55.7%) while 35 cases (44.3%) had to undergo appendectomy. Conclusions: COVID-19 can complicate the perioperative course as a result of direct lung injury and multiple organ dysfunctions and can also bring serious threats to the safety of medical staffs involved in managing the acute appendicitis case operatively, so conservative management can be considered as an alternative way of management of acute appendicitis in the pandemic outbreak.


2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Deepa Chudal ◽  
Sebak Shrestha ◽  
Ruby Shrestha ◽  
Vikash Paudel

Introduction: Rupture uterus is an obstetric catastrophe with poor maternal and fetal outcome. The objective of the study is to determine the prevalence of rupture uterus in pregnancy. Methods: This was a descriptive cross sectional study conducted in a tertiary care centre from January 2016 to December 2016 after taking ethical approval (Approval No. F-NMC-510/76/77) from Institutional Review Committee. Convenience sampling method was used. Data were entered in the Microsoft Excel sheet and obtained data was analysed using Statistical Package for Social Sciences version 18 software for central tendency and frequencies. Results: Out of total 1559 deliveries, prevalence of rupture uterus was found to be 12 (0.0077%). Previous lower segment caesarean scar rupture was the most common risk factor noted in 7 (58.3%) cases. A total of seven patients (58.3%) required intensive care unit admission and blood transfusion. Other maternal complications were surgical site infection 2 (16.67%), sepsis 2 (16.67%), paralytic ileus 1 (8.3%), pelvic collection 1 (8.3%) and vesico vaginal fistula 1 (8.3%). Two maternal deaths (16.67%) and perinatal death was noted in 8 (66.66 % ) cases. Conclusions: Rupture uterus most commonly occurred in scarred uterus. Identification of high risk pregnancy, judicious caesarean section, proper labor monitoring, early diagnosis and prompt management are essential in reducing its occurrences.


2019 ◽  
Vol 6 (17) ◽  
pp. 1300-1305
Author(s):  
Mansi Singh ◽  
Ajay Kumar ◽  
Sanjay Mehrotra ◽  
Virendra Atam ◽  
Ravi Mishra ◽  
...  

2020 ◽  
Vol 58 (222) ◽  
Author(s):  
Nabina Maharjan ◽  
Narayani Maharjan ◽  
Rui Li

Introduction: Hypertension is one of the leading causes of death and disability in both developed and developing countries. The prevalence of hypertension is increasing rapidly worldwide. The aim of the study was to determine the knowledge of diet and exercise among hypertensive patients. Methods: This descriptive cross-sectional study was conducted using a structured questionnaire among 169 hypertensive patients at Kathmandu diabetes and thyroid center from May 2017 to July 2017 after taking ethical clearance from Nepal Health Research Council, Nepal. A convenience sampling method was used. Data was collected and entry was done in Statistical Package for the Social Sciences version 16.0 point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of total 169 participants enrolled in this study, only 79 (46.7%) had good knowledge and 90 (53.3%) had poor knowledge regarding diet and exercise. The mean age of participants was 54.68±13.91 years. Conclusions: This study revealed that the knowledge about diet and exercise among hypertensive patients is poor and this study suggests the need for a proper educational intervention to improve awareness and to control hypertension effectively.


2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Sameer Thapa ◽  
Bishwa Raj Dawadi ◽  
Anup Raj Upreti

Introduction: Acute poisoning is a major global public health problem contributing to one of theleading causes for a visit to an emergency department. This study aims to analyse the demographicand psychosocial characteristics of patients with acute poisoning presented to the emergencydepartment. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital fromJune to December 2019 after obtaining ethical approval from Institutional review board (referencenumber. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, typesof poison consumed, reason, motive, and place to take poison, time elapse in the presentation to thehospital were studied. Statistical analysis was done using statistical package for the social sciencesversion 20. Point estimate at 95% Confidence Interval was calculated along with frequency andproportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%) followedby unknown 12 (15.8). Of total, 28 (36.8%) had quarrel before taking poison and 41 (53.9 %) hadintention to commit suicide. Sixty-seven (88.2%) took a poison at home. The average elapsed time tothe visit of the emergency department was 110±80 minutes.   Conclusions: The most common poisoning was organophosphorus with a suicide being the mostcommon intention. Quarrel was the most frequent reason to take poison and the home was the mostcommon place to take poison.


2021 ◽  
Vol 59 (244) ◽  
pp. 1277-1282
Author(s):  
Arbin Shakya ◽  
Jenash Acharya ◽  
Sunil Joshi

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases inthe Department of Forensic Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done amongst 328 medicolegal cases presenting at a tertiary center, from January 2019 to February 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 2603202101). Convenience sampling was used to select study samples. After detailed history regarding the incidence, injuries were examined and documented in a performa. The data were entered in Statistical Package for Social Sciences version 18. Point estimate at 95% Confidence Interval was calculated along with frequency and percentagefor binary data. Results: Among 328 cases presenting to hospital for medicolegal issues, 237 (72.25%) (67.40-77.09 at 95% Confidence Interval) had injuries, out of which 170 (71.73%) cases were due to physical assault, 64 (27%) cases due to accident; 2 (1.26%) were undetermined. Majority of victims of injury were adult males, with mean age of 32.41±13.96 years. In most accidental injuries internal organs were also injuries and life-threatening. Conclusions: The prevalence of injuries amongst medicolegal cases was found to be higher in our study in comparison to other studies done in similar settings. Most of the injuries were due to physical assault; however, the majority of road traffic injuries were life-threatening. These road traffic injuries could have been prevented by following a safe system approach to road safety.


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