scholarly journals BLOOD TRANSFUSION PRACTICES IN OBSTETRICS AND GYNAECOLOGY AT TERTIARY CARE CENTRE: A RETROSPECTIVE STUDY.

Author(s):  
Shailendra Singh ◽  
Shantipriya Bhardwaj ◽  
Kuldeep Jareda ◽  
Amit Sharma ◽  
Keshari Singh Shekawat

Background: This study was undertaken to ascertain the total patients receiving a transfusion, indications for transfusion, various blood components used, the timing of transfusion, and the presence of any risk factors in the patients transfused. Methods: Transfusion request forms of 2998 patients admitted to the Department of Gynaecology and Obstetrics in the zanana Hospital, SMS Medical College and attached group of hospitals Jaipur from May 2020 to July 2020were retrospectively reviewed for the types and volume of blood component transfused. Indication for each blood component transfusion was noted. Patients who had MOH were further analyzed to estimate the ratio of components transfused. Results: We have experienced 898 obstetric patients who underwent blood component transfusion during the study period. Out of these, 440 (49%) and 458 (51%) were primigravida and multigravida respectively. The mean age of patients who received transfusion was 27 years. The maximum number of patients was in the age group of 21–32 years Conclusion: Anemia during pregnancy is a significant cause of maternal mortality and morbidity. The decision for transfusion was done in this study when the Hb<7 gm%, and there were <4 weeks for delivery or in labor Keywords: Hb, Anemia, Pregnancy.

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.


Author(s):  
Pratibha Garg ◽  
Urmila Tripathi

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.


2021 ◽  
pp. 13-17
Author(s):  
Rabindra Nath Behera ◽  
Sini Venugopal ◽  
Avilas Das

Objective : This is a Prospective cohort study carried out in department of Obstetrics and Gynaecology, Hi-Tech Medical College & Hospital, Bhubaneswar, a tertiary care centre, with the objective of knowing the etiology and outcome of preterm labour and formulate measures to prevent the onset of preterm labour and deal with complications arising from preterm labour. Materials and methods : A total of 112 patients with preterm labour were included in the study. The investigations required to identify the etiology and also other routine investigations were carried out . The study was conducted over a two year period i.e. from November 2018 to October 2020 at Hi-Tech Medical College & Hospital, Bhubaneswar. Results : Majority of the patients were in the age group of 20-24 years. Among them, majority of the patients belonged to the gestational age group of 28-34 weeks . Infection was the commonest cause of preterm labour. There is signicant improvement in neonatal outcome in steroid covered group if gestational age is less than 34 weeks . Conclusion: Preterm labour has major impact on neonatal mortality and morbidity. Hence identication of risk factors and etiologies of preterm labour and timely interventions in the form of investigations and management and preparedness to tackle the maternal and neonatal complications are vital for a good maternal and neonatal outcome.


2020 ◽  
Vol 7 (6) ◽  
pp. 1424
Author(s):  
Vaishnavi Iyengar ◽  
Anjali Parekh ◽  
Sanjay Natu

Background: Audit of transfusion practices in pediatric patients was performed to study indications, clinical profile and whether transfusions were in accordance to guidelines.Methods: Retrospective analysis of all episodes of transfusions from a tertiary care centre was done. The study period was from January 2018 to December 2018.Patients in the age group of 4 months to 12 years were enrolled in the study. The data was reviewed according to the British Committee for Standards in Haematology guidelines for transfusion.Results: During the study period of 12 months,168 units of hemocomponents were transfused to children, 66.07% (111/168) of the total products transfused were packed red cell units, followed by 36 units (21.42%) of fresh frozen plasma and 21 units (12.5%) platelets. Overall usage of blood components was found to be appropriate in 58.33% (98/111). Red blood cells were the most appropriately transfused (64.86 %) (72 units out of 111) blood product as compared to 42.85% of platelets (9/21) and 47.22% of FFP (17/36).Conclusions: Most frequently transfused blood components are red blood cells in pediatrics. Inappropriate transfusion of blood components is hinders the utility of this valuable resource, Thus it becomes necessary to conduct regular audit of blood component transfusion for optimum utilization.


Author(s):  
Smruti Milan Tripathy ◽  
Poonji Gupta ◽  
Akshay Jain ◽  
Probal Chatterji

<p class="abstract"><strong>Background:</strong> Lesions of the oral cavity are very common among the general population and account for a significant number of patients in the outpatient department of otorhinolaryngology. The lesions of oral cavity can cause varied symptoms like pain, dysphagia, and difficulty in speaking. The lesions can range from simple benign conditions to life threatening malignancies.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in the department of otorhinolaryngology, Teerthanker Mahaveer Medical College and Research Centre from January 2019 till December 2019. All the 256 patients who presented to the outpatient department with lesions in the oral cavity during the given time period were included in the study after getting informed and written consent.  </p><p class="abstract"><strong>Results:</strong> Aphthous ulcers were the most common lesion (18.7%) found in this study. Buccal mucosa (50%) and anterior 2/3<sup>rd</sup> of tongue (34.3%) were the most common sites involved. Total of 204/256 (79.6%) patient had some form of addiction which included both smoked and smokeless form of tobacco as the most common type of addiction. Among the tobacco smokers, 24/80 (30%) had pre malignant and malignant lesions while among tobacco chewers 37/76 (48.6%) had pre malignant and malignant lesions.</p><p class="abstract"><strong>Conclusions:</strong> Lesions of the oral cavity are common among Indian population due to high prevalence of tobacco addiction. A thorough history taking and examination can detect premalignant and malignant lesions at an early stage, so that timely treatment can reduce the mortality rates in such patients.</p>


2020 ◽  
Vol 5 (2) ◽  
pp. 1050-1054
Author(s):  
Ram Hari Ghimire ◽  
Ashima Ghimire ◽  
Rupesh Kumar Shreewastav ◽  
Sushil Yadav ◽  
Bidesh Bidesh Bista

Introduction: Hemoptysis is a common but distressing and alarming symptom in a patient. Data related to detail clinical profile and follow up study of hemoptysis are lacking. Objective: This study was carried out to see the clinical profile of patients with hemoptysis and to study the recurrences in tertiary care centre of province 1 within the study period. Methodology: This was a prospective observational study conducted at the department of Pulmonary, Critical Care and Sleep Medicine of Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. The study was carried out between 30th January 2017 to 1st February 2020. For follow up of recurrences of hemoptysis, the patients were asked for regular chest clinic follow up and regular telephone calls made to the patients, in case, patients could not attend the chest clinic for any reason. Results: A total of 150 patients were enrolled over the last 3 years. Among them 75% were male. The maximum number of patients (27%) were between 31-40 years of age group. Old sequelae of pulmonary tuberculosis (PTB) (32%) and bronchiectasis (28%) were the commonest cause of hemoptysis. Lung cancer (10%) and active PTB (10%) were other causes of hemoptysis. CT scan of the chest provided the highest (84%) diagnostic yield. Most of the cases were having mild hemoptysis (50%). 17% of the patients in our study had recurrences of hemoptysis. Conclusion: Old PTB sequelae with bronchiectasis (fibrobronchiectasis) were the commonest cause of hemoptysis. Conservative management worked most effectively in controlling hemoptysis, if used properly.


Author(s):  
Pradnya D. Kamble ◽  
Amarjeet Kaur Bava

Background: Cardiac disease is a leading cause of maternal mortality and morbidity. Timely diagnosis and appropriate management can significantly improve the maternal and perinatal outcome.Methods: This prospective observational study was performed over a period of 18 months at a tertiary care centre in Mumbai. A total of 100 women with heart disease were included in the study. The subjects were followed up during the antenatal, intrapartum and postpartum period to study the maternal and perinatal outcome.Results: Out of 14791 confinements 100 consenting patients were included in the study. The incidence of heart disease came out to 0.9%. Rheumatic heart disease (RHD) was seen more commonly as compared to congenital heart disease (CHD) and peripartum cardiomyopathy. 64% patients delivered vaginally out of which 8% had instrumental delivery and 28% underwent a lower segment caesarean section (LSCS). 21% patients had cardiac complications like pulmonary edema, arrhythmias, sepsis, DIC etc. and there were 3 maternal mortalities. 58% of the babies were born low birth weight, 90.9% of the babies had an Apgar score of >7. 60% of the babies were born at term whereas 26% had a preterm delivery.Conclusions: Patients of cardiac disease with pregnancy need to be managed at a tertiary care centre by a multidisciplinary team of doctors. Early diagnosis of heart disease and stringent management of complication is of utmost importance. Vaginal delivery is favourable and LSCS should be performed for an obstetric indication. Maternal heart disease leads to an increased incidence of preterm delivery and hence a joint care of neonatologist is mandatory in managing these patients.


Author(s):  
Meenakshi B. ◽  
Shantaraman K. ◽  
Indhumathi M. ◽  
Arumugapandian S. Mohan

Background: Snake-bites are well-known common medical emergencies in many parts of the world. In India 46,000 people are dying every year from snakebites. However, the true scale of mortality and morbidity from snake-bite remains uncertain. This study analyses the clinical profile and outcomes of the snake bite poisoning in patients admitted to this centre.Methods: This cross sectional study analyses the data of 150patients admitted to the Intensive Medical Care Unit of Tirunelveli Medical College Hospital with the history of snake bite between April and September of 2015 as available in their case records.Results: In this study, 42.7% of the patients were in the age group of 18 to 40 years and 64% were males with rural: urban ratio of 2.3: 1. About 82.7% of bites were haematotoxic, 10.7% neurotoxic and the remaining nontoxic bites. About 54% patients recovered completely, 44% had some form of morbidity at discharge and mortality was 2%. Out of 136 patients who were treated with Anti-snake venom (ASV), 9.6% developed ADR. The common ADR was itching and hypotension followed by rigor, breathlessness and edema of lips and eyes.Conclusions: This study highlights the need for early treatment intervention post bite. Imparting health education about early pre-hospital management and transfer to the hospital will help in the prevention of deaths due to snakebite. Identification of the type of snake is essential to decide on the type of toxicity and method of treatment to be instituted.


Author(s):  
Ramamani Dalai ◽  
Rajashree Rout ◽  
Manjula Pradhan ◽  
Prasanta Kumar Nanda

Background: Central Serous chorioretinopathy (CSCR) is one of the common causes of visual handicap affecting young people of highly intellectual professionals at the peak of their career which can lead to irrecoverable loss of vision.Methods: The present prospective observational population-based study was conducted in the Department of Ophthalmology, S.C.B. Medical College, Cuttack, Odisha from October 2013 to September 2015. The total number of patients attended the Outpatient Department (OPD) during the study period were 1,83,199. Amongst which 123 patients diagnosed to have CSCR were selected for the present study.Results: Incidence of CSCR during in this study period was 0.06%. The age group most commonly affected was 31 to 40 years. Males were affected 7 times more commonly than females. Increased incidence was noticed in bank employees (21.1 %) and IT professionals (17.8%).Conclusions: There was increased incidence of the disease in people under stressful life condition.


Author(s):  
Meghna Sachin Vaidya ◽  
Juhi Balwant Kawale ◽  
Parag Rajkumar Maheshkar ◽  
Aniket Namdev Kamble

Background: Malaria, leptospirosis and dengue fever are the predominant monsoon related illnesses in the Indian subcontinent causing considerable mortality and morbidity. These have similar clinical profile and derangement in one or more haematological parameters. We have studied the haematological profile at presentation to differentiate one infection from the other as it presents a significant diagnostic challenge to the treating physician.Methods: A prospective observational study of haematological profile in a total of 336 patients of malaria (plasmodium falciparum, plasmodium vivax and mixed malaria), dengue and leptospirosis were conducted over a period of 1 year in a tertiary care centre in western Maharashtra.Results: In the age group of 20-40 years all the infectious subgroups were observed to have the maximum number of patients with a male preponderance. Maximum frequency of Haemoglobin in leptospirosis was 7-10gm%. Maximum mortality in mixed malaria and leptospirosis was seen with haemoglobin levels <7gm%. In P. vivax malaria, P. falciparum malaria and dengue mortality was not seen in patients with Hb<7gm%.Conclusions: Leucocytosis is most commonly seen in leptospirosis. Patients presenting with leucopenia are most likely to have P. vivax malaria. Mixed malaria was most likely to have thrombocytopenia on presentation. Haemoglobin of <7gm% in leptospirosis and mixed malaria probably predicts a poor outcome.


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