scholarly journals Management of Gastroschisis in a Tertiary Care Hospital

2013 ◽  
Vol 36 (3) ◽  
pp. 133-138
Author(s):  
MA Rashid ◽  
MM Hoque ◽  
AA Mamun ◽  
A Kabir ◽  
M Ibrahim ◽  
...  
Keyword(s):  
Birth Weight ◽  
Survival Rate ◽  
Abdominal Wall Defect ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Developed Countries ◽  
Management Plan ◽  
Care Hospital ◽  
Number Of Patients ◽  
Neonatal Icu

Background : Gastroschisis is a congenital abdominal wall defect with high mortality in developing countries. In developed countries their survival rate is more than ninety percent. This is due to appropriate information about the disease and adequate management plan. We have a good number of patients, but majority of us are lacking appropriate information about this disease. Objectives: This study was done to give some information to our medical personals about this disease and to evaluate the out come of gastroschisis in relation to birth weight, age of neonate and procedure of closure of the defect. Methodology: This prospective observatinal study was done in the surgery department of Dhaka Shishu Hospital (DSH) in a period of two years. All gastroschisis patients admitted during this period were enrolled and their mortality were analyzed in relation to weight, age and operative procedure. Minimal intervention management of gastroschisis (MIMG) were performed in suitable cases. Results: A total of 32 patients were admitted. Mortality were significantly high among the VLBW babies than babies whose birth weight > 1500 gm (88.9% vs17.4%) and those who were admitted after 24 hours of age than who admitted before 24 hours of age (66.7% vs26.1%). Overall survival rate was 62.5% and after surgery 71.5%. Conclusion: Gastroschisis is not rare in our population. Birth weight, early hospitalization with primary closure as early as possible, proper selection of patient for MIMG effect outcome. Adequate supportive measures like TPN, neonatal ICU and information about the disease will further increase the survival rate. DOI: http://dx.doi.org/10.3329/bjch.v36i3.14276 BANGLADESH J CHILD HEALTH 2012; VOL 36 (3) : 133-138

scholarly journals Surgical Diseases Management during COVID-19 Crisis at a Tertiary Care Hospital of India: Our Institutional Strategy

2021 ◽  
Vol 07 (04) ◽  
pp. e366-e373
Author(s):  
Sudhir Kumar Singh ◽  
Amit Gupta ◽  
Harindra Sandhu ◽  
Rishit Mani ◽  
Jyoti Sharma ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Tertiary Care Hospital ◽  
Multiorgan Failure ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Hospital ◽  
Advanced Malignancy ◽  
Number Of Patients ◽  
Surgical Conditions

Abstract Introduction In response to the national coronavirus disease 2019 (COVID-19) pandemic, all hospitals and medical institutes gave priority to COVID-19 screening and to the management of patients who required hospitalization for COVID-19 infection. Surgical departments postponed all elective operative procedures and provided only essential surgical care to patients who presented with acute surgical conditions or suspected malignancy. Ample literature has emerged during this pandemic regarding the guidelines for safe surgical care. We report our experience during the lockdown period including the surgical procedures performed, the perioperative care provided, and the specific precautions implemented in response to the COVID-19 crisis. Materials and Methods We extracted patient clinical data from the medical records of all surgical patients admitted to our tertiary care hospital between the March 24th, 2020 and May 31st, 2020. Data collected included: patient demographics, surgical diagnoses, surgical procedures, nonoperative management, and patient outcomes. Results Seventy-seven patients were included in this report: 23 patients were managed medically, 28 patients underwent a radiologic intervention, and 23 patients required an operative procedure. In total eight of the 77 patients died due to ongoing sepsis, multiorgan failure, or advanced malignancy. Conclusion During the COVID-19 lockdown period, our surgical team performed many lifesaving surgical procedures and appropriately selected cancer operations. We implemented and standardized essential perioperative measures to reduce the spread of COVID-19 infection. When the lockdown measures were phased out a large number of patients remained in need of delayed elective and semi-elective operative treatment. Hospitals, medical institutes, and surgical leadership must adjust their priorities, foster stewardship of limited surgical care resources, and rapidly implement effective strategies to assure perioperative safety for both patients and operating room staff during periods of crisis.

scholarly journals Impact of COVID-19 Pandemic and Pattern of Patient Care in Otorhinolaryngology Practice in a Tertiary Referral Centre

2021 ◽  
Author(s):  
Kalpana Sharma ◽  
Abhilasha Goswami ◽  
S. M. Sarun
Keyword(s):  
Healthcare Workers ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Tertiary Referral Centre ◽  
Adequate Treatment ◽  
North East ◽  
Innovative Methods ◽  
Number Of Patients

AbstractTo study the effect of COVID-19 pandemic on patient load in a tertiary care centre and the innovations and methods used to improve the safety of the healthcare workers, to provide adequate treatment in the department of Otorhinolaryngology. This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, at a tertiary care hospital centre in North-East India. This study included data collected from the patient registers maintained in our department, and included data over a 4-month period, from April, 2020 to July, 2020. Age, gender, place of residence, clinical diagnosis and the operative procedure performed were included in the data profile for analysis. The above-mentioned registers were also reviewed to retrieve details about the rate of admission during the study period in the previous year. Data was collected and represented, in both descriptive and tabular forms, after proper statistical analysis. We found out that there is a drastic reduction in number of patients attending in our department of Otorhinolaryngology during this COVID-19 pandemic. Certain innovative methods for protecting healthcare workers from viral transmission were put into our practice based on the peer reviewed articles, from June, 2020 and the rate of elective procedures and in-patient admissions were thus increased. Knowledge of new innovative methods in Otorhinolaryngology will help overcome the difficulties faced during the current COVID-19 pandemic.

scholarly journals Frequency of Retinopathy in low birth weight infant at tertiary care hospital.

2020 ◽  
Vol 27 (02) ◽  
pp. 365-370
Author(s):  
Muhammad Younis Tahir ◽  
Iftikhar Ahmad ◽  
Soufia Farrukh
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Oxygen Supplementation ◽  
Low Birth Weight Infant ◽  
Number Of Patients ◽  
Department Of Ophthalmology

Objectives: To find out the frequency of retinopathy in low birth weight infant presenting at tertiary care hospital, Bahawalpur. Study Design: Cross sectional study. Setting: Department of Ophthalmology, Bahawal Victoria Hospital, Bahawalpur. Period: From July 2018 to December 2018. Material & Methods: Neonatal eye examination was performed for ROP. Results: Total 78 neonates were recruited for present study and ROP was assessed. Mean gestational age of neonates was 32.54 ± 3.79 weeks. Mean weight was 1445.51 ± 517.373 grams. Out of 78 neonates, ROP was observed in 28 (36%) neonates. ROP was found in 27 (42.19%) neonates of premature group and in 1 (7.14%) neonates of at term group. ROP was found in 1 (3.23%), 5 (29.41%) and 22 (73.33%) neonates respectively in weight group 1500-2500 g, 1000-1500 g and <1000 g group. Male neonates were 35 (44.87%) and female neonates were 43 (55.13%). Development of ROP was not significantly (P = 0.248) associated with gender of the neonates. Statistically significant association between ROP and oxygen supplementation was observed with p value 0.021. Conclusion: Results showed higher number of patients with ROP. Association of development of ROP with gestation was highly significant. Oxygen supplementation and oxygen concentration was also associated with ROP. Findings also showed no effect of gender and duration of hospital stay on ROP.

scholarly journals Outcome of paediatric rhabdomyosarcoma attended in a tertiary care hospital, Dhaka, Bangladesh

2020 ◽  
Vol 46 (1) ◽  
pp. 17-21
Author(s):  
ATM Atikur Rahman ◽  
Momena Begum ◽  
CSH Kibria ◽  
Mehnaz Akter ◽  
Khurshida Azad Siddiqua ◽  
...  
Keyword(s):  
Survival Rate ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
Stage Iv ◽  
Developed Countries ◽  
Multimodality Therapy ◽  
Care Hospital ◽  
Advanced Stage ◽  
Advanced Stages

Background: Rhabdomyosarcoma (RMS) is a malignant tumor of mesenchymal origin, is the most common form of paediatric soft tissue sarcoma. It is the third most common solid tumor comprising 4.5% of all childhood cancer with an annual incidence of 4.5 cases per million children. There is so no statistical data on RMS in Bangladesh because no study has done in Bangladesh. Objective: To evaluate the clinical characteristics and treatment outcome of children with rhabdomyosarcoma among tertiary care. Methods: A retrospective study carried out analysing the medical records of 39 patients with rhabdomyosarcoma from the BSMMU tumor registry. Medical records of children with rhabdomyosarcoma were reviewed over a period of 6 years from June 2011 to May 2017.  Most patients received multimodality therapy (chemotherapy, surgery, radiotherapy). Results: The male female was ratio 1.2:1. More than half of cases presented with a mass at varying sites The predominant complaint 12.0% was pain. The primary site of disease was the head and neck in 46.0% followed by pelvis 40.0%. Pathologically most frequent histological subtype was in 46.0% embryonal rhabdomyosarcoma followed by alveolar rhabdomyosarcoma 23.0%, botryoid type 5.0%, spindle cell type 5.0% and unspecified 21.0%.  At the time of diagnosis 64.0% of patients were TNM stage 3 next frequency is stage IV 23.0%. The survival rate from diagnosis to subsequent demise was poor – between 13 days and 3.5 years. The overall 5-year survival rate was 41.0% which is may be due to advanced stage of disease. Conclusion: The majority of presentations were in the advanced stages of disease but sensitive to multimodality therapy. Poor survival rate is correlated with the advanced stage of the disease. The clinical characteristics of rhabdomyosarcoma at BSMMU Hospital are similar to worldwide countries, but not like developed countries. Further multicentre studies are needed to report our experiences with rhabdomyosarcoma. Bangladesh Med Res Counc Bull 2020; 46(1): 17-21

scholarly journals Prevalence of Depression in Patients with Chronic Backache

2019 ◽  
Vol 7 (2) ◽  
pp. 4-8
Author(s):  
Sandip Subedi ◽  
Alok Pandey ◽  
Shirish Aryal
Keyword(s):  
Tertiary Care ◽  
Developed Countries ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Prevalence Of Depression ◽  
Icd 10 ◽  
Minimum Age ◽  
History Of

INTRODUCTION:-Backache is a common problem with about 70% of people in developed countries experience low back pain at some time in their lives. A number of studies done previously shows that there is high prevalence of depression in patients with chronic backache. This study was carried out to find out the prevalence of depression in patients with chronic backache in Nepalese subjects. MATERIAL AND METHODS:-This was a cross-sectional descriptive study conducted in Universal College of Medical Sciences, Bhairahawa, Nepal. Patients presenting to Orthopaedics OPD with history of backache lasting for more than 12 weeks were referred for psychiatric evaluation. One Hundred cases were included in the study based on inclusion / exclusion criteria in six months period (from 1st  Jan 2019 to 30th  June 2019). Detailed evaluation was done by a psychiatrist to find out the presence of depression. Diagnosis of depression was made based on ICD-10 DCR. Data was analysed using SPSS. RESULTS: Out of total 100 subjects, more than half (56%) were females. Majority of the subjects (61% ) were below 45 years of age. The average age of the subjects was 45 years minimum age being 16 and maximum 77. About 59% were also suffering from depressive disorder. CONCLUSION: This study concludes that significant number of patients with chronic backache attending OPD of tertiary care hospital suffers from depression. It is therefore essential to screen for depression in these patients.

scholarly journals Study of TORCH infections and its impact on newborn babies and infants: a retrospective study in a tertiary care hospital in Visakhapatnam, Andhra Pradesh, India

2020 ◽  
Vol 8 (12) ◽  
pp. 4417
Author(s):  
Sai Prabha Chilakala ◽  
Appa Rao P. ◽  
Ramalakshmi K. ◽  
Suresh Babu Chaduvula
Keyword(s):  
Nephrotic Syndrome ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Andhra Pradesh ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Torch Infections

Background: TORCH is an acronym for Toxoplasma, others (syphilis), Rubella, Cytomegalovirus and Herpes simplex virus. These are important causes of morbidity and mortality in new-borns, infants and children. Early diagnosis and treatment are essential to reduce the morbidity and mortality.Methods: It was a cross sectional record based retrospective record-based study conducted in King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh. Samples from clinically suspected cases (newborns and infants) for possible TORCH infections were tested in virology laboratory from January to November 2019 and the samples were collected and tested by EUROIMMUN kit for the respective IgM antibodies and analyzed. Clinical details of newborns and infants were gathered from the patients through telephonic communication.Results: Total number of patients tested were 104 in which 54 (52%) showed positivity in which 36 were positive for CMV, 25 for HSV2, 23 for Rubella, 12 for Toxoplasma and 11 for Varicella zoster infection. Out of 52 positive cases 20.4% were alive and normal, 20% were alive but severely affected, mortality was 16.7%. Out of 16.7% mortalities 22% of deaths were due to nephrotic syndrome. Clinical manifestations include hepato-splenomegaly in 33.3% cases, fever in 30%, low birth weight in 25%, heart disease in 13.7%, microcephaly in 13.7%.Conclusions: Our study showed hepatomegaly, fever and low birth weight as common clinical manifestations. Fever and nephrotic syndrome were typically associated with CMV positive cases. Out of 52 % positively tested cases CMV was very common infection followed by HSV2, Rubella and Toxoplasmosis.

scholarly journals Impact of COVID-19 Pandemic and Pattern of Patient Care in Otorhinolaryngology Practice in a Tertiary Referral Centre

2020 ◽  
Author(s):  
Kalpana Sharma ◽  
Abhilasha Goswami ◽  
Sarun S M
Keyword(s):  
Healthcare Workers ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Tertiary Referral Centre ◽  
Adequate Treatment ◽  
North East ◽  
Innovative Methods ◽  
Number Of Patients

Abstract Aims-To study the effect of COVID-19 pandemic on patient load in a tertiary care centre and the innovations and methods used to improve the safety of the healthcare workers, to provide adequate treatment in the department of Otorhinolaryngology.Materials and methods-This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, at a tertiary care hospital centre in North-East India. This study included data collected from the patient registers maintained in our department, and included data over a 4-month period, from April, 2020 to July, 2020. Age, gender, place of residence, clinical diagnosis and the operative procedure performed were included in the data profile for analysis. The above-mentioned registers were also reviewed to retrieve details about the rate of admission during the study period in the previous year. Data was collected and represented, in both descriptive and tabular forms, after proper statistical analysis.Results-We found out that there is a drastic reduction in number of patients attending in our department of Otorhinolaryngology during this COVID-19 pandemic. Certain innovative methods for protecting healthcare workers from viral transmission were put into our practice based on the peer reviewed articles, from June,2020 and the rate of elective procedures and in-patient admissions were thus increased.Conclusion- Knowledge of new innovative methods in Otorhinolaryngology will help overcome the difficulties faced during the current COVID-19 pandemic.

scholarly journals Anterior abdominal wall defects: Demographic and clinical profile and outcome at a tertiary care hospital

2021 ◽  
Vol 10 ◽  
pp. 20
Author(s):  
Parveen Kumar ◽  
Vivek Manchanda ◽  
Mamta Sengar
Keyword(s):  
Birth Weight ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Pediatric Care ◽  
Abdominal Wall Defects ◽  
Care Hospital

Background: The anterior abdominal defects, especially gastroschisis and omphalocele have high mortality rates in developing countries. Time to intervene has been hypothesized to be associated with morbidity and mortality. The aim was to determine factors affecting mortality in neonates with anterior abdominal wall defects. Methods: This retrospective descriptive study was done at a tertiary pediatric care center. The medical records of patients with a diagnosis of anterior abdominal defects (omphalocele/gastroschisis/umbilical cord hernia) admitted at our center from Jan 2015 to Dec 2019 were retrieved. The demographic and clinical data were studied including age, sex, religion, gestational age, associated anomalies, electrolytes at admission, septic profile, operative details, length of hospital stay, and mortality. The statistical data was fed on a Microsoft Excel worksheet and analysis was done. Results: Thirty-nine (39) neonates were included in the study. M:F ratio was 2:1, with 61.5% belonging to the Hindu religion. The majority had term gestation (87.2%). Birth weight ranged from 1.5 to 4 kg (mean 2.47 + 0.5 kg). Eighteen (18) neonates had gastroschisis, 15 omphalocele major and 6 omphalocele minor, with a median age of presentation at 1 day of life. Time to intervention ranged from 0 to 5 days (interquartile range 1-1.25 days) after admission. Primary closure could be achieved in the majority (66.7%), while ventral hernia was created in 17.9% and the silo was needed in the rest. The mean postoperative length of stay was 9.31 days (+ 9.85 days) with a survival rate of 51.3%. The mortality rate in gastroschisis and omphaloceles were 61.1% and 38.1% respectively. The significant factors for survival were time to intervene, birth weight, and primary abdominal wall closure. Conclusions: The present study brings out a different clinical profile of anterior abdominal wall defect patients. We recommend early surgery soon after stabilization and primary abdominal wall repair whenever abdominal pressures permit.

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.

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