scholarly journals ROBSON’S CLASSIFICATION OF CAESAREAN SECTION CONDUCTED AT A TERTIARY CARE WOMEN’S HOSPITAL

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Nishtha Agrawal ◽  
Neha Agrawal
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Total Duration ◽  
Primary Source ◽  
World Health ◽  
Care Hospital ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
The World ◽  
Primiparous Women

Background: Despite the World Health Organization’s recommendation and caution the cesarean section rates are continuously rising across the world. This despite the evidence indicating that this increase in c-section rate is not leading to a decline in the maternal and child mortality rates. The objective of this study was to classify and categories all the primary c-section conducted among multi-parous women delivering at a tertiary care hospital.  Material and Methods: An observational, cross-sectional, single centre study was conducted at the Sultania Zanana Hospital affiliated to Gandhi Medical College, Bhopal. The total duration of the study was one year from April 2013 to March 2014.  The study population comprised of the multi-parous women coming or referred to SHZ.  The primary source of the data for this study where the patient’s interview, treatment records and operation theatre delivery register.  Results: During the period between April 2013 to March 2014, a total of 10,271 deliveries were conducted at SZH; of these 7,570 were normal vaginal deliveries and 3,151 were c-section. The prevalence of primary cesarean section in multipara in the present study is 5.6 %.  Most (62.0%) women were categorized as belonging to the III group while only 2.1% of women were categorized in the VIII group. Discussion:  A large number of primary c-section among primiparous women can be prevented. In comparison to primiparous women, the prevalence of primary c-section was less among multiparous women.

scholarly journals Drug Prescription in the Department of Medicine of a Tertiary Care Hospital according to the World Health Organization/International Network for Rational Use of Drugs Core Indicators: A Descriptive Cross-sectional Survey

2021 ◽  
Vol 59 (240) ◽  
Author(s):  
Jyoti Tara Manandhar Shrestha ◽  
Saurabh Tiwari ◽  
Dilip Kumar Kushwaha ◽  
Pratigya Bhattarai ◽  
Ruchi Shrestha
Keyword(s):  
Drug Use ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
International Network ◽  
Rational Use ◽  
The World

Introduction: To establish appropriate health care services in developing countries, rationalization of drug use holds utmost importance. Drug use patterns can be found out using Core Indicators of the World Health Organisation in collaboration with the International Network of Rational Use of Drugs. With the help of the indicators, this study aimed to find out the way the drugs were prescribed in the Medicine out-patient department of a tertiary care hospital. Methods: A descriptive cross-sectional survey was conducted from October 2019 to March 2020 in a tertiary care hospital. The ethical approval was taken from the Institutional Review Committee of the Dhulikhel hospital (reference number 198/19). Convenient sampling was done. After taking consent from the patient, data was collected from prescriptions written on the patient's card. The data were analysed using Statistical Package for the Social Sciences Version 25. Descriptive statistics were applied and the results were expressed as frequency and percentage, mean and standard deviation. Results: A total of 559 prescriptions were analysed, of which a total of 1427 medicines were found to be prescribed with an average number of medicines per the prescription of 2.55±1.388. Drugs prescribed by generic name were 820 (57.5%), antibiotics were 138 (9.7%) and injections were 8 (0.6%). Drugs prescribed from the Essential Drug List of Nepal was 939 (65.8%). Conclusions: Our study revealed that despite some results being up to the mark, there is a requisite for the proper regulation of prescribing and dispensing drugs in order to promote rationalisation.

scholarly journals Current practices and evaluation of barriers and facilitators to surgical site infection prevention measures in Jimma, Ethiopia

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Leigh R. Berman ◽  
Andrew Lang ◽  
Beshea Gelana ◽  
Samuel Starke ◽  
Dawd Siraj ◽  
...  
Keyword(s):  
Systems Engineering ◽  
Infection Prevention ◽  
Medical Center ◽  
Tertiary Care ◽  
Barriers And Facilitators ◽  
World Health ◽  
Care Hospital ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
The World

Abstract Objective: Surgical site infections (SSIs) greatly burden healthcare systems around the world, particularly in low- and middle-income countries. We sought to employ the Systems Engineering Initiative for Patient Safety (SEIPS) model to better characterize SSI prevention practices and factors affecting adherence to prevention guidelines at Jimma University Medical Center (JUMC). Design: Our cross-sectional study consisted of semistructured interviews designed to elicit perceptions of and barriers and facilitators to SSI prevention among surgical staff and observations of current preoperative, perioperative, and postoperative SSI prevention practices in surgical cases. Interviews were recorded, manually transcribed, and thematically coded within the SEIPS framework. Trained observers recorded compliance with the World Health Organization’s SSI prevention recommendations. Setting: A tertiary-care hospital in Jimma, Ethiopia. Participants: Surgical nurses, surgeons, and anesthetists at JUMC. Results: Within 16 individual and group interviews, participants cited multiple barriers to SSI prevention including shortages of water and antiseptic materials, lack of clear SSI guidelines and training, minimal Infection Prevention Control (IPC) interaction with surgical staff, and poor SSI tracking. Observations from nineteen surgical cases revealed high compliance with antibiotic prophylaxis (94.7%), hand scrubbing (100%), sterile gloves and instrument use (100%), incision site sterilization (100%), and use of surgical safety checklist (94.7%) but lower compliance with preoperative bathing (26.3%), MRSA screening (0%), and pre- and postoperative glucose (0%, 10.5%) and temperature (57.9%, 47.3%) monitoring. Conclusions: Utilizing the SEIPS model helped identify institution-specific barriers and facilitators that can inform targeted interventions to increase compliance with currently underperformed SSI prevention practices at JUMC.

scholarly journals Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

2020 ◽  
Author(s):  
Abhishek Sharma ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
World Health ◽  
Respiratory Pattern ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
History Of ◽  
Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p<0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p<0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p<0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

PRESCRIPTION PATTERN OF PSYCHOTROPIC DRUGS IN A PSYCHIATRY OPD OF A TERTIARY CARE HOSPITAL – A CROSS SECTIONAL STUDY.

2021 ◽  
pp. 191-194
Author(s):  
Kishore M S ◽  
Narendra Kumar ◽  
S Sindhu
Keyword(s):  
Psychotropic Drugs ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prescription Pattern

Background: The expanding and challenging eld of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Psychotropic drugs utilization in actual clinical practice, effectiveness and safety in the real-life situation needs continuous study. Therefore, the study was undertaken to analyze the prescription pattern of psychotropic drugs. Methods: A Cross sectional study was conducted in the psychiatry out-patient department of a tertiary care hospital for 4 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators. Results: Psychotropic drugs constituted 74.85% of the prescribed medication. Average number of the psychotropic drugs per prescription was 2.53. Percentage of prescriptions with injectable drugs accounted for 5.13%. 59.28% of the drugs were prescribed by generic names, while the rest were branded. 28% of prescriptions contained psychotropic FDCs (Fixed dose th combination). 78.65% of the drugs were from the WHO's 18 List of Essential Medicines. Among the total psychotropic drugs prescribed, antipsychotics (43.87%) were the most commonly prescribed class of drugs followed by antidepressants (23.32%), anxiolytics (22.13%) and the mood stabilizers (9.88%) were the least. Conclusions: Prescription pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. Antipsychotics were the most commonly prescribed psychotropic drugs.

scholarly journals Non-Clinical Variables Influencing Cesarean Section Rate According to Robson Classification

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 180
Author(s):  
Noemi Strambi ◽  
Flavia Sorbi ◽  
Gian Marco Bartolini ◽  
Chiara Forconi ◽  
Giovanni Sisti ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Healthcare Setting ◽  
Care Hospital ◽  
Public Practice ◽  
Clinical Variables ◽  
Robson Classification ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Private And Public

Background and Objectives: The incidence of cesarean section (CS) has progressively increased worldwide, without any proven benefit to either the mother or the newborn. The aim of this study was to evaluate the association between CS rates and both clinical and non-clinical variables, while applying the Robson classification system. Materials and Methods: This is a retrospective observational study of pregnant women delivering at a tertiary care hospital between 2012 and 2017, either under public or private healthcare. The overall CS rate, and the elective and non-elective CS rate, divided by classes of Robson, were determined. The rate of vaginal deliveries and CSs was compared between the public and private setting. The distribution of incidence of non-elective CSs and their main indications were analyzed between daytime and nighttime. Results: 18,079 patients delivered during the study period: 69.2% delivered vaginally and 30.8% by CS. Robson class 5 was the most frequent (23.4%), followed by class 2B (16.8%). Of the 289 private practice deliveries, 59.2% were CSs. The CS rate was significantly higher in private compared to public practice: 59.2% and 30.4%, respectively (OR 3.32, 95% CI 2.62 ± 4.21). When only considering elective CSs, a statistically significant difference was found in Robson class 5 between private and public practice, with the latter having more CSs (94.2% and 83.8%, respectively (p = 0.046)). The rate of non-elective CS was significantly lower during nighttime than during daytime (17.2% vs. 21.5%, p < 0.01). During daytime, the higher incidence of CS occurred between 4:00 and 4:59 pm, and during nighttime between 9:00 and 9:59 pm. Failed induction was significantly more common as an indication to CS during daytime when compared to nighttime (p = 0.01). Conclusions: This study identified two non-clinical variables that influenced the CS rate: the type of healthcare setting (private vs. public) and the time of the day. We believe that these indications might be related more to the practitioner attitude, rather than objective delivery complications.

scholarly journals Frequency and Severity of Depression in Cancer Patients Presenting to Tertiary Care Hospital

2021 ◽  
pp. 59-70
Author(s):  
Rakesh Kumar ◽  
Haresh Kumar ◽  
Sarika Bai ◽  
Azra Shaheen ◽  
Safdar Ali Pervez ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Depression ◽  
World Health ◽  
Care Hospital ◽  
Validity And Reliability ◽  
Mild Depression ◽  
Cross Sectional ◽  
Civil Hospital

Introdution: Cancer and depression, independently, cause massive human suffering worldwide. By the end of 2030 the unipolar major depression disorder could be as the chief source of ailment as estimated by World Health Organization. Objective: Objective of this study is to detect prevalence the frequency and severity of the depression in cancer patients presenting to tertiary care hospital of Karachi. Methodology: The current prospective cross-sectional research was performed over a period of six months from August 2020 to January 2021 on 179 patients in the Department of Oncology of Civil Hospital Karachi, after approval of synopsis from CPSP and the ethical committee of Civil Hospital. All patients who fulfilled the inclusion criteria and visited OPD of Civil hospital were selected in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study.Patients were assessed clinically by using ICD-10 criteria and then for validity and reliability, patients were screened for presence of depression and its severity through PHQ-9.Patients scoring higher than 4 was labeled as having depression and PHQ-9 score of 5 to 9, 10 to 14, 15 to 19, 20-27 were labeled mild, moderate, moderately severe and severe depression correspondingly. Observed data was entered in the predesigned Performa was gathered and SPSS version 20.0 was used for data analysis. Mean ± SD of age was 47.75±14.901years. Out of 179 patients 95 (53.1%) were male and 84 (46.9%) were female. 93(52%) cancer patients were depressed while 86(48%) were normal. Patients suffering from mild depression were 3.2%, moderate depression were 54.85%, moderately severe depressed were 19.4%, while 22.6% cancer patients were severely depressed. It is to be concluded that out of 179cancer patients 93(52%) diagnosed to have depression while 86(48%) did not have depression. Based on our study findings, it is suggested that depression commonly presented in cancer patients and there is a need to screen all cancer patients for depressive disorder.

scholarly journals Socio-Demographic Profile and Self-Injurious Behavior among Patients with Mania at a Tertiary Care Hospital

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
L Versi
Keyword(s):  
Age Of Onset ◽  
Bipolar Affective Disorder ◽  
Tertiary Care ◽  
Total Duration ◽  
Cross Sectional Study ◽  
Variable Degree ◽  
Care Hospital ◽  
Impulsive Behavior ◽  
Cross Sectional ◽  
Study Results

Background: Mania is a common mood disorder. Mania associated with distractibility, irritability, impulsive behavior, great physical and mental activity. Irritability and impulsive behavior can lead to variable degree of self-injurious behavior. Self-injurious behavior more troublesome to patient and family members, there is a lack of proper research in the field of self-injurious behavior and mania. Objective: To assess the sociodemographic profile of self- injurious behavior in mania and self- injurious behavior in relation to severity of mania. Methods: Present study was a hospital based cross sectional study. The study was conducted at a tertiary care psychiatric hospital for a period of 6 months. 40 Patients with bipolar affective disorder with currently Mania with or without psychosis were included in the study. Patients with other psychiatric disorder were excluded from the study. Results: The mean age of study subjects was 29.75+7.012. The overall prevalence of self-injurious behavior among patients with mania was 37.5%. Cutting was seen in 4 males and 4 female patients. Burned with a cigarette and Burned with a lighter was seen only in one male patient. The age of onset of cutting and banged was seen at around 26 years of age. Total duration of mania for cutting was around 14 years and 17 years for head banged. Conclusion: The overall prevalence of self-injurious behavior among patients with mania was 37.5%. This was more in females as compared to males. But the difference is narrow and cannot be statistically significant.

scholarly journals Anxiety among Pregnant Women about Corona Virus Infections during COVID-19 Pandemic at a Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Dipty Shrestha ◽  
Rachana Saha ◽  
Naresh Manandhar ◽  
Asmita Adhikari ◽  
Jyoti Dahal
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Physical Interaction ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
The World ◽  
Severe Anxiety

Introduction: COVID-19 is a beta coronavirus that is transmitted by physical interaction or close contact. This Coronavirus Pandemic has also created stress and anxiety among pregnant women all over the world. The disease was first identified in Wuhan city, China, in late December 2019 and was declared pandemic by the World Health Organization on 11th March 2020. Concern and stress in pregnancy are associated with pre-eclampsia, intrauterine growth restriction, preterm labour, depression etc. Pregnancy is an immune-compromised state and poses a high risk to this risk. This study aims to identify anxiety about the coronavirus infection among pregnant women visiting a tertiary care centre in Kathmandu, Nepal, during this COVID–19 pandemic. Methods: This is a descriptive cross-sectional study conducted at Kathmandu Medical College and Teaching Hospital from 15th July 2020 to 30th July 2020 after taking the ethical clearance from the Institutional Review Committee of Kathmandu Medical College. Convenient sampling method was used. All the data were entered in Statistical Package for the Social Sciences data 20.0 and analyzed. Data was presented in frequencies, charts and percentage. Results: Among the total 273 cases, only 2 (0.73%) case had a score between 25-30 corresponding to moderate to severe anxiety, 21 (7.69%) had a score between 18-24, which corresponds to mild to moderate anxiety and 250 (91.57%) had score 0-17 which corresponds mild status. Conclusions: Most of the participants in the study reported a mild status of anxiety. Very few participants reported moderate to severe anxiety.

scholarly journals Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

2019 ◽  
Vol 8 (6) ◽  
pp. 1430
Author(s):  
Rucha M. Shinde ◽  
Anand S. Kale ◽  
Mahadeo P. Sawant
Keyword(s):  
Tertiary Care Hospital ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Brand Names ◽  
Outpatient Department ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional

Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.

scholarly journals Robson’s Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1098-1101
Author(s):  
Pratigyan Gautam ◽  
Chanda Karki ◽  
Asmita Adhikari
Keyword(s):  
Caesarean Section ◽  
Confidence Interval ◽  
Cesarean Section ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 2

Introduction: Globally, there is a dramatic rise in cesarean section rate which has increased the maternal morbidity and adverse effects in a subsequent pregnancy. Robson’s classification will aid in the optimization of the cesarean section use, assessment of the strategies aimed to decrease the cesarean section rate and thus improve the clinical practices and quality of care in various health care facilities. The main aim of this study is to find out the prevalence of caesarean section for Robson’s group 2 among total caesarean sections done in a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out at a tertiary care centre in Nepal from August 2020 to January 2021. Ethical approval was taken from the institutional review committee (reference number: 1607202003) and data were entered using Robson’s criteria. The convenient sampling technique was used. Data was analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: According to Robson’s group 10 classification, among 380 caesarean sections, 110 (28.94%) (24.38-33.50 at 95% Confidence Interval) cases were in Robson’s group number 2. Conclusions: This study showed that the prevalence of caesarean section which lies in Robson’s group 2 in our study is higher than the standard of World Health Organization. It showed that Robson’s group 2 was one of the significant contributors to the greater caesarean section rate. Improved case selection, standardization, and protocol for induction of labour as well as regular audit could also reduce caesarean section rates.

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