scholarly journals Prevalence of nutritional anemia in children of high socioeconomic status in a tertiary care center

2021 ◽  
Vol 8 (10) ◽  
pp. 359-361
Author(s):  
Pradeep Kalaiselvam ◽  
Suresh Chelliah ◽  
Meganathan Pachamuthu
Keyword(s):  
Socioeconomic Status ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Hypochromic Anemia ◽  
World Health ◽  
High Socioeconomic Status ◽  
Nutritional Anemia ◽  
Study Results ◽  
Tertiary Center

Background: Anemia is a highly prevalent condition developed in children belonging to all socioeconomic status and is mainly caused due to iron deficiency in nutrition. Aim: To identify the Prevalence of nutritional anemia in children of high socioeconomic status. Methods: Children between 6 months and 14 years of age belonging to high socioeconomic status, admitted in pediatric ward of Kauvery Hospital, a tertiary center at Trichy were included in the study. Children with hemolytic anemia, chronic illnesses, and those who received blood transfusion were excluded from the study. The World Health Organization classification was used for grading the severity of anemia as mild, moderate, and severe based on hemoglobin levels for the age. Modified Kuppuswamy scale 2016 was used to assess the socioeconomic status of the children. Children belonging to upper and upper middle socioeconomic status were included in the study. Results: The overall prevalence of anemia among the study population was 44.5%. Out of 400 subjects, 178 participants were anemic. Of the 178 anemic children, 78.1% were in the age group of 6 months–5 years, 20.2% in 5–11 years, and 1.7% in 12–14 years. Among children between 6 and 23 months, 75 were anemic. Almost all patients showed microcytic hypochromic anemia. There were a significantly higher number of overweight and obese children among those anemic in all age groups. Conclusion: This study concludes that every other child is anemic even in families of high socioeconomic status, especially <2 years of age. There is an urgent need to screen and treat all children regardless of their socioeconomic status or body mass index.

scholarly journals A clinical study of anemia in children aged 6 months–5 years in a tertiary care center, Bengaluru, Karnataka, India

2021 ◽  
Vol 8 (10) ◽  
pp. 367-370
Author(s):  
Siva Saranappa ◽  
Jennifer Wu
Keyword(s):  
Nutritional Status ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
World Health ◽  
Deficiency Anemia ◽  
Age Group ◽  
Female Ratio ◽  
Male Predominance ◽  
Health Organization

Background: Anemia is the most commonly observed hematological diseases in children. The World Health Organization (WHO) has estimated that globally, 1.62 billion people are anemic, with the highest prevalence of anemia (47.4%) among preschool-aged children. Of these 293 million children, 89 million live in India. Aim: This study aims to evaluate the factors causing anemia in children aged between 6 months and 5 years and its prevalence within this age group. Methods: This study is a prospective observational study conducted in KIMS Hospital, Bengaluru, Karnataka. A total of 200 children in the age group of 6 months–5 years with features of anemia or having hemoglobin <11 g/dl were included in the study for a duration of 18 months between January 2019 and June 2020. Detailed history was recorded and examination findings were noted. The data collected were tabulated and statistically analyzed accordingly. Results: About 57.5% of the children with anemia fell between the age group of 6 months and 2 years and 42.5% of children were in the age groups of 2–5 years. A male predominance was seen (61%) with male-to-female ratio of approximately 1.56:1. Most of the children were found to have mild (46%) and moderate anemia (46%) with only a minority (8%) presenting with severe anemia. About 56.5% of the children had a normal nutritional status while 41% were malnourished and 2.5% had both wasting and stunting. Exclusive breastfeeding (for 6 months) history was present in 59% of the children. These children belonged mostly to the upper lower (45%) and lower middle (41%) socioeconomic status. This study also showed anemia in children most commonly presented majorly with concurrent involvement of the respiratory system (31%) followed by infectious diseases (30%) and gastrointestinal disorders (23%). Conclusion: The current study concludes that iron deficiency anemia is a multifactorial hematological disease. Learning about the predisposing risk factors can help to adopt the necessary precautions to prevent anemia in these children. Improving the nutritional status of the children by involving parents and counseling them regarding important feeding practices can help to prevent anemia.

scholarly journals Cesarean Section Rate at Lumbini Zonal Hospital, Nepal: An Analysis Using the Robson Ten Group Classification System

2020 ◽  
Vol 7 (1) ◽  
pp. 9-14
Author(s):  
Bishnu Gautam ◽  
◽  
Shree D. Acharya ◽  
Vishnu Prasad Sapkota ◽  
Raut B. Batsal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
World Health ◽  
Cross Sectional ◽  
Study Results ◽  
Group 5 ◽  
Group 1

Background Caesarean section (CS) rates have increased globally. The World Health Organization (WHO) recommends the use of the TenGroup Robson classification as the global standard for assessing appropriateness of CS. Nepal has higher-than-global average rates of CS requiring further investigation into appropriateness. Aim This study aims to investigate the caesarean section rates at tertiary care center in Nepal and make analysis based on the group-10 classification. Methods A retrospective cross-sectional study was carried out from 2016 April -2017 March in Lumbini Zonal Hospital, Butwal, Rupendehi, Nepal. 3,817 women who birth over a 12-month period were analyzed using this classification. The caesarean rate, its indications were calculated and categorized into groups according to Robson’s 10-group classification. Results Women with previous CS (Group 5) comprise the largest proportion (9.4%) of the overall 26.41% CS rate. The second largest contributor was a singleton nulliparous woman with cephalic presentation at term (6.6% of total 26.41%). Caesarean section rates in single breech pregnancies were very high (>65%). Robson’s Group 5 was the highest contributors to overall CS rate contributing 35% of all C-sections, followed by Group 2 (24%), and Group 1 (13%). Conclusion The ten-group classification helped to identify the main groups of the subjects who contribute the most to the overall caesarean section rate. This study results suggest that women with previous CS are at risk for having another CS delivery in subsequent pregnancies and therefore there is an urgent need for a dedicated vaginal birth after caesarean section (VBAC) clinic to support this such women to ensure CS are only done when indicated. Furthermore, reducing the CS rate for nulliparous i.e. Group 1 and 2 would, in the long-term, also reduce the size of Group 5 in the future.

scholarly journals Profile and outcome of pediatric intussusception: a 5-year experience in a tertiary care center

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Aqeela J. Madan ◽  
Fayza Haider ◽  
Saeed Alhindi
Keyword(s):  
Seasonal Variation ◽  
Success Rate ◽  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Operative Intervention ◽  
Secondary Outcome ◽  
Lead Point ◽  
Pneumatic Reduction ◽  
Tertiary Center

Abstract Background Intussusception is the most frequent cause of bowel obstruction in infants and toddlers; idiopathic intussusception occurs predominantly under the age of 3 and is rare after the age of 6 years; the highest incidence occurs in infants between 4 and 9 months; the gold standard for treatment of intussusception is non-operative reduction. This research will tackle the problem of pediatric intussusception in our center which is the largest tertiary center in our region. The primary outcome is to study the profile of intussusception; the secondary outcome is to assess the success rate of pneumatic reduction in the center’s pediatric population as well as to study the seasonal variation if present. Results During the study period, eighty-six (N=86) cases were identified, from which 10 cases were recurrent intussusception. Seventy-six (N=76) cases were included from the study period. N=68 (89%) were less than 3 years of age, and only N=2 (3%) were above 6 years. Seasonal variation was not significant; N=69 (91%) patients had successful pneumatic reduction under fluoroscopy while thirteen patients N=13 (17%) needed operative intervention. Conclusion Ileocolic intussusception is one of the most common pediatric surgical emergencies that can be successfully managed non-operatively in our institute; 89% of the cases were below 3 years of age, and no seasonal variation was demonstrated. Operative intervention was required in 13 cases with the main reason being lead point. The fact that the pediatric surgeon performs the reduction might have contributed to a high success rate reaching 91% in our center. This study provides a valuable opportunity for future regional data comparisons and pooled data analyses.

scholarly journals Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

2021 ◽  
Vol 27 ◽  
pp. 107602962110228
Author(s):  
Bushra Moiz ◽  
Ronika Devi Ukrani ◽  
Aiman Arif ◽  
Inaara Akbar ◽  
Muhammed Wahhaab Sadiq ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Activated Protein C ◽  
Positive Association ◽  
Cerebral Venous Sinus Thrombosis ◽  
P Value ◽  
Middle Income ◽  
Duration Of Symptoms

Pediatric cerebral venous sinus thrombosis (CVST) is rare but a potentially fatal disease requiring its understanding in local setting. In this study, we observed the clinical course, management, and outcome of pediatric patients with sinus thrombosis in a tertiary care center at Pakistan. Patients between age 0 to 18 years of both genders diagnosed with sinus thrombosis during 2011 to 2020 were included. Data was collected through in-house computerized system and SPSS version 19 was used for analysis. Of 143492 pediatric admissions, 32 (21 males and 11 females) patients with a median (IQR) age of 4.5 years (0-16) had CVST. This is equivalent to 18.5 CVST events per million pediatric admissions. Adolescents were mostly affected, and the overall mortality was 7%. Primary underlying disorders were infections (59%), hematological neoplasms (12.5%), thrombotic thrombocytopenic purpura (3%) and antiphospholipid syndrome (3%). Activated protein C resistance (44%) was the most common inherited thrombophilia. Twenty-one (66%) patients were anemic with a mean (±SD) hemoglobin of 9.0 g/dL (±2.3). Regression analysis showed a positive association of anemia with multiple sinus involvement ( P-value 0.009) but not with duration of symptoms ( P-value 0.344), hospital stay ( P-value 0.466), age ( P-value 0.863) or gender ( P-value 0.542) of the patients. SARS-COV2 was negative in patients during 2020. Adolescents were primarily affected by sinus thrombosis and infections was the predominant risk factor for all age groups, with a low all-cause mortality. A high index of clinical suspicion is required for prompt diagnosis and intervention.

Histopathological Study of Cystoscopic Bladder Biopsies in a Tertiary Care Center

2021 ◽  
Vol 6 (1) ◽  
pp. 1310-1314
Author(s):  
Rachana Dhakal ◽  
Hem Nath Joshi ◽  
Ramesh Makaju ◽  
Shailendra Sigdel
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Pathological Condition ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
World Health ◽  
Histopathological Study ◽  
Neoplastic Lesion ◽  
Neoplastic Lesions

Introduction: Non-neoplastic urinary bladder lesions are not life threatening, but are an important source to cause clinical symptoms and signs. However, neoplasms of the bladder are a source of morbidity, mortality, and exhibit more clinical challenges. Cystoscopy provides overall information about an anatomical/pathological condition of the urinary bladder which will be helpful for patients' management. A cystoscopic biopsy is a primary diagnostic tool for diagnosing urinary bladder cancer. Objectives: The objective of the study was to find the frequency and histomorphological characteristics of urinary bladder lesions in Dhulikhel Hospital, to find the clinical presentation of urinary bladder lesions and to grade the urothelial tumors based on the World Health Organization (WHO)/ International Society of Urological Pathology (ISUP) classification 2004. Methodology: This was a retrospective, cross-sectional, observational study carried out in the Department of Pathology, Dhulikhel Hospital-Kathmandu University Hospital. Convenient sampling was done. All cystoscopy biopsies received from January 2014 to December 2018 were studied. All tissue blocks were retrieved, cut, and stained with Hematoxylin and Eosin. The stained slides were examined under a light microscope by the primary investigator. Result: A total of 70 cystoscopic biopsies were analyzed. The majority of patients 20 (28.6%) were in the age group between 60 and 69 years and males were predominant 43 (61.4%). The neoplastic lesions constituted 40 (57.1%) of all bladder lesions, among them urothelial carcinoma accounted for 38 (54.2%). Similarly, chronic cystitis 27(38.6%) was the most common non-neoplastic lesion. Conclusion: The study found that the neoplastic lesions were commonly encountered in urinary bladder lesions. Among them, lowgrade urothelial carcinoma was the most common bladder tumor. However, most of the non-neoplastic lesions were inflammatory in origin. Cystoscopy combined with histomorphological examination helps in the early detection of bladder lesions. 

Fetomaternal Outcome of Pregnancy with COVID-19: An Observational Study in Tertiary Care Hospitals of Pakistan

2021 ◽  
Vol 15 (6) ◽  
pp. 1903-1906
Author(s):  
Nabila Khan ◽  
Zahra Wasim ◽  
Aesha Sadaf Rizwan ◽  
Afshan Ahmad ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Negative Impact ◽  
Heart Defects ◽  
Tertiary Care ◽  
World Health ◽  
Observational Research ◽  
Military Hospital ◽  
Corona Virus ◽  
Study Results ◽  
The World

Background: The new corona virus first appeared in Wuhan, China in December 2019 and has since spread around the world to other countries. The World Health Organization believes that this new CoV-19 epidemic is a public health emergency of international concern (PHEIC) on January 30, 2020Worldwide.The mortality rate of this viral infection ranges from 2% in Pakistan to 14.4% in Italy. Lympopenia, elevated transminase, proteinuria, increased LDH, and C-reactive protein levels are all common laboratory findings in the early stages of the disease. Covid patients have experienced a variety of complications, including extreme pneumonia, ARDS, heart defects, sepsis and septic shock, and respiratory tract super infection. Methodology: This retrospective observational research study was carried out at the Gynecology Unit of MardanMedical Complex, Mardan and Combined Military Hospital, Risalpur for 06 months duration from April 2020 to September 2020. In a pre-constructed data collection form, biochemical and radiological parameters of medical history, test results, symptoms, pregnancy, and neonatal outcomes were noted. Patients treated in an outpatient setting were not included in the study. Results: There were 121 patients in total, with mean age of 27 having standard deviation ± 5, having range 19-40 years. 48.3% pregnant women reported their first pregnancy(primigravida). 51.3% of SARS-Cov-2 were in their 3rd trimester while 34.7% were in their 35-40 weeks of gestational age. Common complications are gestational hypertension (PIH) (16 cases), hypothyroidism (14 cases) and gestational diabetes (GDM) 9 cases. More than half (53%) of patients are asymptomatic. Common symptoms are cough (22%) and fever (11%). The incidence of multiple organ failure was 2% as shown in table 01. Lymphopenia was common (84%). A CT scan of 24 patients showed bilateral invasion. Conclusion: COVID-19 has a negative impact on the foetus, according to our results. Although pregnant women do not seem to be more vulnerable to COVID-19 complications than non-pregnant adults, previous research has suggested that pregnant women could be at higher risk for negative pregnancy outcomes such as preterm birth, foetal pain and respiration, symptoms, and LBW in a newborn baby. Keywords: Corona virus, COVID-19, Pregnancy, Outcome.

scholarly journals Knowledge attitude practice and acceptance of postpartum intrauterine devices among postpartal women in a tertiary care center

2017 ◽  
Vol 6 (4) ◽  
pp. 1507 ◽  
Author(s):  
Sumitra Yadav ◽  
Ruchi Joshi ◽  
Monica Solanki
Keyword(s):  
Family Planning ◽  
Retention Rate ◽  
Low Cost ◽  
Care Center ◽  
Tertiary Care ◽  
School Level ◽  
World Health ◽  
Common Reason ◽  
Eligibility Criteria ◽  
Expulsion Rate

Background: PPIUCDs are the only method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum phase. World Health Organization (WHO) medical eligibility criteria state that it is generally safe for postpartum lactating women to use a PPIUCD, with the advantages outweighing the disadvantages. PPIUCDs are cost-effective and they are low-cost intervention that reduces maternal, infant, and under-five Child mortality.Methods: After approval from the ethical committee and consent from the patients, the study was performed on 1000 postpartum women within 10 min. of delivery and up to 6 weeks of delivery at Labour Room of, M.Y. Hospital, Indore.Results: Majority of acceptor (72.5%) belong to age group of 18-25 years and 53% belonged to urban area. Acceptance was more in those who completed their secondary school level education (33%). Working women (55.5%) accepted PPIUCD more than the non-working. Out of 1000 women counselled only 10% agreed for PPIUVD insertion. During the study of 1 year duration (3.5%) of non-acceptors become pregnant and none of the acceptors conceived. Most common reason stated for accepting PPIUCD among acceptors, was that it is a reversible method (66%). Most common reason for not accepting PPIUCD among non-acceptors, because they are interested in Other Method of Family Planning (60%).Conclusions: Verbal acceptance is more than actual insertion of PPIUCD because of adoption of other method of family planning, family pressure, nonacceptance by partner, lack of awareness, fear of complication. Proper counselling can help to generate awareness and compliance for PPIUCD use in postpartum mother who have institutional delivery. Inserting CuT 380A within 10 min after placental delivery is safe and effective, has high retention rate. The expulsion rate was not high, and further can be reduced with practice could not be predicted.

scholarly journals Complications and Outcome of Pregnancy in Extremes of Reproductive Age Groups: Experience at Tertiary Care Center

2016 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Manju Lata Verma ◽  
Sabuhi Qureshi ◽  
Uma Singh ◽  
Nisha Singh ◽  
Pushpa Lata Sankhwar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Reproductive Age ◽  
Tertiary Care Center

COMPARATIVE STUDY OF E-STRIP AND VITEK 2 FOR VANCOMYCIN MIC FOR STAPHYLOCOCCUS AUREUS AT TERTIARY CARE CENTER

2021 ◽  
pp. 8-10
Author(s):  
Gauri Thakare ◽  
Sonal Chavan ◽  
Sharmila Raut ◽  
Rajani Tore ◽  
Ravindra Khadse
Keyword(s):  
Staphylococcus Aureus ◽  
Comparative Study ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Care Center ◽  
Tertiary Care ◽  
Test Material ◽  
Methicillin Resistant ◽  
Study Results ◽  
Vitek 2 ◽  
Strip Test

PURPOSE: Comparative Study done for Vancomycin susceptibility in Methicillin Resistant Staphylococcus aureus (MRSA) in two methods Vitek-2 and E-strip test. MATERIAL AND METHOD: Vancomycin susceptibility testing was performed on these Methicillin Resistant Staphylococcus aureus (MRSA) isolates by two methods viz. Vitek 2 & E- strip Test. RESULT: A total of 10680 various specimens were received and processed in laboratory. 210 samples were S. aureus amongst which 76 were MRSAs. Pus was the predominant sample followed by endotracheal secretions, blood, and sputum. All the strains of MRSA found susceptible to vancomycin (MIC≤ 2µg/ ml) by both the methods. Maximum specimens by both the methods had MICs of 1.0 µg/ ml. CONCLUSION: In the present study results of Vitek and E-strip were almost comparable. In the advanced era of automation and computerized technology with manpower compromised labs, Vitek could be a better option for vancomycin MIC.

scholarly journals Assessment of indications of caesarean section among high risk women by Robson criteria: a prospective study

2018 ◽  
Vol 7 (7) ◽  
pp. 2623
Author(s):  
Kaveri Shaw Patel ◽  
Roma S. Nag
Keyword(s):  
High Risk ◽  
Caesarean Section ◽  
Care Center ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Group Classification ◽  
Classification Systems ◽  
World Health ◽  
Qualitative Assessment ◽  
Safe Delivery

Background: Caesarean section (CS) is a surgical intervention for safe delivery other than natural vaginal route. World Health Organization (WHO) has recommended ten group classification systems of Robson criteria which we have used to analyse CS at our center. The objective of the study to analyse the lower section caesarian section (LSCS) data under Robson criteria for implementation in regular practice in tertiary care center and to understand the need of it for future practice.Methods: A prospective analysis done for deliveries in Obstetric Department of Shalby Multispecialty Hospital of central India by Robson ten group classification criteria. The study was carried out for the period of two year from April 2016 to April 2018 including antenatal women attending labour room with high risks or referred cases from other centers.Results: The study reflected overall 196 live birth of high risk cases which were having other co morbidities like pre-eclampsia, eclampsia, hypothyroidism, diabetes, acute viral hepatitis. The data compared with Robsons guidelines and reflected that the centre is dealing with high risk primigravida (47.51%, 35-42% Robson criteria) cases with high CS rate (16.8%, group 5). There was multiple pregnancy, group 8, (2.32 %, >1.5-2% Robson Criteria) and preterm births as in group 10, 18.02 % (5% in Robson Criteria), exclusively high.Conclusions: The Robson criteria help to classify the population handled by the canter to develop the strategies for betterment of services. It has limitation in view of qualitative assessment of the data for comorbidities and severity of the disease.

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