scholarly journals Clinical Presentation of Preterm Neonates with Intraventricular Hemorrhage: Experience in a Tertiary Care Hospital in Dhaka

2017 ◽  
Vol 7 (3) ◽  
pp. 194-197
Author(s):  
Tasnima Ahmed ◽  
Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar
Keyword(s):  
Clinical Features ◽  
Intraventricular Hemorrhage ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Sudden Onset ◽  
Morbidity And Mortality ◽  
Preterm Neonates ◽  
Cranial Ultrasound ◽  
Care Hospital ◽  
One Year

Background: Intraventricular hemorrhage (IVH) is common among preterm infants as many of them survive with the advancements in neonatal care. Severe IVH may lead to significant morbidity and mortality. The objective of our study is to find out the significant clinical signs of IVH in preterm neonate for early detection by ultrasonography.Methods: This prospective observational study was done in special care baby unit (SCABU), Bangladesh Institute of Research & rehabilitation of Diabetic, Endocrine & metabolic Disorder (BIRDEM) for a period of one year. Eighty five preterm neonates were included in this study. Clinical features of IVH like- convulsion, lethargy, irritability, bulged fontanelle, recurrent apnea, sudden onset of respiratory distress, sudden pallor and bradycardia were observed. Cranial ultrasound studies were done within 7 days of life in all cases to identify IVH.Result: Mean gestational age of these neonates was 31.31(±2.2) weeks & mean birth weight was 1413.42 (±330.55) gm. Among 85 preterm neonates 21(24.7%) developed IVH, confirmed by ultrasonography of brain. Clinical features like convulsion, bulged fontanel, repeated apnea & sudden pallor were significantly present in IVH group.Conclusion: Intraventricular Hemorrhage constitutes an important cause of morbidity and mortality in neonate. This study showed that clinical features like convulsion, bulged fontanel and sudden pallor had a significant relationship with intraventricular hemorrhage which will help for its early detection.Birdem Med J 2017; 7(3): 194-197

scholarly journals Morbidity and Mortality Outcome in Late Preterm Neonates at a Tertiary Care Hospital

2016 ◽  
Vol 12 (1) ◽  
pp. 44-47
Author(s):  
Tahsinul Amin ◽  
Ayesha Najma Nur
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Late Preterm ◽  
Morbidity And Mortality ◽  
Respiratory Morbidity ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Neonates ◽  
Late Preterm Infants ◽  
Significant Difference

Introduction: The morbidity and mortality in late preterm neonates is higher than term neonates. The main reason is the relative physical and neurologic immaturity, though there is no significant difference in the weight or the size of the two groups. Objective: The study was conducted to compare the early neonatal morbidity and mortality (within first 7 days of life) in late preterm infants (34–36 6/7 weeks) with those in term neonates (37–41 6/7 weeks). Materials and Methods: This was a prospective study conducted from 01 January 2015 to 30 June 2015 in the department of Neonatology at a tertiary hospital. Results: Total 100 neonates were included in the study; fifty neonates in each group. Late preterm infants had significantly higher morbidity due to any cause, e.g. respiratory morbidity (p<0.05), jaundice (p<0.05), hypoglycemia (p<0.05), sepsis (p<0.05) and perinatal asphyxia (p<0.05). Early neonatal mortality in late preterm neonates was significantly higher than term neonates (p<0.05). Conclusion: Late preterm neonates are at high risk for morbidity and mortality as compared to term neonates. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 44-47

scholarly journals CRANIAL ULTRASOUND IN DETECTION OF NEUROLOGICAL LESIONS IN PRETERM NEONATES IN A TERTIARY CARE HOSPITAL – A PROSPECTIVE OBSERVATIONAL STUDY.

2020 ◽  
pp. 23-25
Author(s):  
Badri kumar Gupta ◽  
Nand kishor Gupta ◽  
Prem Yaday ◽  
Sadan Mukhi
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Preterm Neonates ◽  
Cranial Ultrasound ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cranial Ultrasonography

BACKGROUND: Incomplete formation and maturation of the central nervous system makes it extremely vulnerable to injury, in the case of premature neonates. This can result in a broad range of neurodevelopmental abnormalities. Cranial ultrasound is a sensitive tool for the early detection of these.Preterm neonates, defined as childbirth occurring at less than 37 completed weeks of gestation, is a major determinant of neonatal mortality and morbidity because of their greater risk for intraventricular hemorrhage (IVH) and hypoxic ischemic encephalopathy (HIE). The morbidity associated with preterm birth often extends to later life, resulting in enormous physical, psychological and economic costs. Currently, many imaging modalities are available like Cranial Ultrasonography, Computed Tomography and Magnetic Resonance Imaging to detect the intracranial abnormalities in these neonates. However advantages of Cranial Ultrasonography are easy availability, not expensive, easy to perform, quick, can be done at bedside, repeatable and radiation free. The aims of the study were to identify the severity of brain injuries by grading the neurosonographic findings and to correlate the clinical presentations with the neurosonographic findings. MATERIALS AND METHODS: This study is done in Department of pediatrics in Neonatal Intensive Care Unit in Universal College of Medical Sciences ,a tertiary care hospital, Bhairahawa. This cross-sectional study comprise of 60 preterm neonates, referred to Department of Radio diagnosis for cranial ultrasonogram. Ultrasound examination of the neonatal brain done through anterior fontanelle in coronal and sagittal planes within 1st week using healthcare logiq p6 pro ultrasound machine. RESULTS: In this cross-sectional study of 60 neonates, 46 were male and 14 were female. Among 60 babies, 30 (50%) showed normal study and remaining 30 (50%) showed abnormal scan. Among the cases which were abnormal on scan most common finding was GMH (33.3%) and next commonest was periventricular leucomalacia (PVL- 16.7%) noted in 10 babies. CONCLUSION: Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.

scholarly journals The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

2017 ◽  
Vol 4 (3) ◽  
pp. 809
Author(s):  
Sanjay A. Mundhe ◽  
Siddheshwar V. Birajdar ◽  
Sheshrao S. Chavan
Keyword(s):  
Clinical Features ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Care Facility ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Prognostic Information ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Suicidal Intention

Background: Organophosphates (OP) are commonly used and potentially fatal insecticides. Given the unrestricted availability and widespread use, OP poisoning is very much common following either accidental or intentional exposures. Many parameters are proposed to predict outcome, yet there is no consensus about these parameters. This study aimed to investigate different factors associate with morbidity and mortality in rural population that can help in identifying patients in need of intensive care and treatment to prevent deaths.Methods: This was a cross-sectional observational study of 323 patients, admitted to the tertiary care rural public hospital with OP poisoning between December 2015 to November 2016.Results: Of the 323 patients studied, 62.85% were male, 227 (70.27%) were suicides, 241 (74.61%) ingested OP compounds, 40 (12.38%) patients developed intermediate syndrome and 56 (17.34%) died. There were statistically significant differences between ventilatory support group and no ventilatory group for suicidal intention, sex, comorbid psychiatric conditions, route of exposure, certain clinical features on admission, GCS score, POP scale, time from exposure to initiation of treatment, plasma pseudocholinesterase levels, oxygen saturation, and random blood sugar  levels (p<0.05).Conclusions: OP poisoning is a life-threatening condition which requires immediate management. Early initiation of decontamination, atropine and pralidoxime therapy, with supportive ICU care, can save lives. Different demographic, exposure related parameters; some of the clinical features, treatment variables and certain laboratory findings can provide useful prognostic information and help to predict outcomes. A measures to control unchecked availability of these compounds and early transfer of victims to health care facility is needed to save many lives.

scholarly journals An epidemiological study of poisoning trend in sonipat Haryana region-A one year study

2021 ◽  
Vol 6 (3) ◽  
pp. 118-121
Author(s):  
Yogesh Kumar Vashist ◽  
Yogender Malik ◽  
Gaurav Sharma ◽  
Balraj Sharma ◽  
Sunil Kumar ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Public Health Problem ◽  
Acute Poisoning ◽  
The Body ◽  
Morbidity And Mortality ◽  
North India ◽  
Care Hospital ◽  
Important Public Health Problem ◽  
Effective Prevention ◽  
One Year

Poison is a substance that causes damage or injury to the body and endangers one’s life due to its exposure by means of ingestion, inhalation, or contact and it is an important public health problem causing significant morbidity and mortality throughout the world. Hence, this study was done at tertiary care Hospital in north India (Haryana region) from year 2012 to 2013. 59 cases of acute poisoning in adults due to chemicals were included. Data on age, sex, marital status, occupation, locality, type of poison, were recorded and analyzed by descriptive method. Among 120 postmortem cases, 59 cases were of poisoning. Males (40 cases) outnumbered females (19 cases) and 46 cases were married. Peak occurrence was in the age group of 31-40 years (18 cases). Occupation wise poisoning was commonly found among male laborers (25.4%) and farmers (20.3%) followed by house wives (28.1%) and students (6.8%). Organophosphorus was the commonest agent (42.4%). The incidence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies.

scholarly journals Incidence, Clinical Signs and Co-morbidities of Feeding Intolerance among Preterm Infants Aged 28-34 Weeks of Gestation in a Tertiary Care Hospital of Western Nepal- A Prospective Observational Study

2021 ◽  
Author(s):  
Binod Kumar Gupta ◽  
Ranjana Bista ◽  
Sandeep Shrestha ◽  
Deepak Raj Bhandari ◽  
Raju Kaphle ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Abdominal Distension ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Feeding Intolerance

Introduction: Feeding intolerance is common among the preterm neonates and is associated with different co-morbidities like respiratory depression, respiratory distress syndrome, apnea, hyperbilirubinaemia, and hypoxic ischaemic encephalopathy. Aim: To find the incidence of feeding intolerance in preterm neonates from 28-34 weeks of gestation along with the clinical signs and co-morbidities associated with feeding intolerance. Materials and Methods: A prospective observational hospital based study was conducted in Neonatal Intensive Care Unit (NICU) and postnatal ward of Universal College of Medical Sciences, a tertiary care hospital situated in western Nepal for 12 months (June 2018 to May 2019). All admitted preterm neonates between 28-34 weeks of gestation were included in the study and were followed-up for any neonatal morbidities along with feeding intolerance. Feeding intolerance was defined when the newborn had vomiting and/or abdominal distension and/or increased gastric residual volume with normal disruption of feeding process. Babies with feeding intolerance were subjected to final analysis for clinical signs and co-morbidities. Results: Out of 490 admitted preterm babies (28-34 weeks), 54 (11.02%) had feeding intolerance with 33 (61.1%) babies in the very low birth weight group. The mean birth weights of the total enrolled babies (n=490) and feed intolerant (n=54) babies were 1550 gm and 1418 gm, respectively. Different co- morbidities associated with feeding intolerance were respiratory distress (25.9%), respiratory distress syndrome (22.2%), jaundice (16.7%), apnea (5.6%) and necrotising enterocolitis (3.7%). Among the total 37 preterm deaths, four babies were in the feeding intolerance group. Majority of all feed intolerant babies had vomiting 49 (90.7%) followed by gastric residue (57.4%), abdominal distension (55.6%), and reduced or absent bowel sounds (7.4%), respectively. The incidence of feeding intolerance was increased in babies fed with formula feed (p=0.46) and when feeding was started <24 hours (p=0.22) but the results were statistically insignificant. Conclusion: The incidence of feeding intolerance was 11.02% in the preterm neonates (28-34 weeks) with high proportion in very low birth weight babies. Vomiting, gastric residue and abdominal distension were three important signs of feeding intolerance in newborns.

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

Abstract 147: Hypertension-related Admission and Mortality at a Referral Hospital in Tanzania - A Call to Action

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Naomi Shike ◽  
Santosh Vardhana ◽  
Judith Briant ◽  
Robert Peck
Keyword(s):  
Heart Failure ◽  
Medical Center ◽  
Tertiary Care ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
Hospital Death ◽  
Care Hospital ◽  
Common Cause ◽  
Related Disease ◽  
Reasonable Approach

Introduction The WHO has been increasingly emphasizing and calling for research on the vast unattended burden of non-communicable diseases in the developing world. Hypertension (HTN) in particular is thought to play a growing role in morbidity and mortality in these regions, but has yet to gain significant momentum in public health initiatives. Objective To determine what role HTN and comorbid diseases play in admission and mortality in Bugando Medical Center (BMC), a tertiary care hospital in Tanzania serving 13 million people. Methods We conducted a retrospective analysis of all patients admitted to the internal medicine service at BMC over 34 months between 2008 and 2011. Data on admission diagnoses and mortality had been collected prospectively by Tanzanian doctors in hand-written logs. For patients with heart failure or stroke, the ward logs specified if this was primarily related to hypertension or other risk factors. Data were copied into an Excel database and analyzed to determine the proportion of admissions and deaths primarily related to hypertension. Results In 34 months 8,037 patients were admitted and 1,508 died. HTN-related disease led to 1,997 admissions (25%), while HIV-related illness led to 2,076 (26%). Similarly, HTN led to 377 deaths (25%) and HIV to 579 (38%). HTN-related disease was second only to HIV-related disease as a cause of admission and death. Among hypertensives, the most common cause of admission was congestive heart failure (446; 27%) and of death was stroke (147; 49%). In non-hypertensives, HIV-related disease was the most common cause of both admission (2029; 32%) and death (566; 46%). Conclusions HTN-related disease was second only to HIV as a cause of admission to our hospital and in-hospital death. Better strategies for early diagnosis and treatment of HTN are desperately need in sub Saharan Africa to prevent this morbidity and mortality. Building HTN screening and treatment on top of the extensive infrastructure for HIV disease may be a reasonable approach.

Clinical Audit of Obstetrical Hysterectomies for a Period of One Year in A Tertiary Care Hospital

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Farzana Latif ◽  
Sadia Ilyas ◽  
Saeed Mehmood ◽  
Hammad Arif ◽  
Nuzhat Parveen Khawaja ◽  
...  
Keyword(s):  
Gestational Age ◽  
Tertiary Care Hospital ◽  
Clinical Audit ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hospital Record ◽  
Record System ◽  
Peripartum Hysterectomy ◽  
Emergency Peripartum Hysterectomy ◽  
One Year

Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus. Key Words: Uterine artery embolization, Emergency peripartum hysterectomy, maternal morbidity and mortality, healthcare providers How to Cite: Latif F, Ilyas S, Mehmood S. Arif H. Khawaja P. Nuzhat. Jawad Z. J Clinical audit of obstetrical hysterectomies for a period of one year in a tertiary care hospital. Esculapio.2020;16(04):50-53.

A CLINICOEPIDEMIOLOGICAL STUDY ON PAEDERUS DERMATITIS IN A TERTIARY CARE CENTRE, CHENNAI

2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sudden Onset ◽  
The Body ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Tertiary Care Centre ◽  
Linear Lesions ◽  
Paederus Dermatitis

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.

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