scholarly journals Audit of Emergency Obstetric Referrals- A Pilot Study From Tertiary Care Centre of North India

2016 ◽  
Vol 30 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Neelam Aggarwal ◽  
Rimpi Singla ◽  
Lakhbir Dhaliwal ◽  
Vanita Suri

Objective (s):The aim of the study was to find out the characteristics of emergency obstetric referrals, to evaluate the lapses in the existing referral system and to suggest the plausible solutions to improve the obstetric health care delivery system in India.Materials and methods: This prospective descriptive study was carried out in the Department of Obstertrics and Gynaecology PGIMER Chandigarh India from September 2012 to December 2012.All the obstetric emergency referrals to our institute, a tertiary care centre in North India were critically reviewed for reason for referral, adequacy of care provided before referral, lapses in management, factors behind suboptimal care and remedial measures are suggested.Results: There were 232 emergency referrals available for analysis. Of these 76% patients were referred directly to the institute, the highest level in referral chain in the region. Mean age was 26yrs, 28.6% of the patients were illiterate. In 75.5% of cases, the management of obstetric emergency before referral was suboptimal or poor. In 16% of cases patient failed to seek medical help timely despite emergency. In 40% of cases there was undue delay in referring or failure to provide even the basic care. Anticipated premature delivery and hypertensive disorders of pregnancy were the most common diagnosis at referral.Conclusion: Results from this pilot study shows that in spite of the most extensive health care infrastructure and so- called hierarchal referral system, there is gross inadequacy in referral system in India.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 25-29

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 48-49
Author(s):  
Javaid Ahmad Bhat ◽  
Shariq Rashid Masoodi

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.


Healthline ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 100-107
Author(s):  
Arti Agrawal ◽  
Vikas Kumar ◽  
Sanjeev Kumar ◽  
Neha K Mani

Introduction: Dengue virus infection is a major public health issue prevalent in tropical and sub-tropical countries all over the world mostly in urban and semi-urban areas. WHO estimates about 50-100 million dengue infections worldwide every year. The present study is aimed to assess the prevalence and seasonal distribution of dengue disease during three consecutive years from 2016-2018 at a tertiary care centre of North India. Method: This is an observational retrospective study conducted on total 6,481 clinical suspected cases referred from indoor and outdoor departments of Medicine and Pediatrics of one of the medical colleges of Agra during the period from 1st January 2016 to 31st December 2018. Results: The maximum positivity was recorded in the year 2016 (16.66%), followed by 2017 (14.07%) and 2018(13.56%).Our study shows male preponderance with maximum cases in the year 2018 was recorded in the month of October (22.75%) whereas the lowest in the month of May (1.96%). Most of the cases were in the age group 0-30 years with a male preponderance. The outbreak occurred during the months of August to November indicating vector transmission in the monsoon and post-monsoon season. Conclusion: From the analysis, this study reflects that the numbers of dengue cases in 2016 were maximum and outnumbered the dengue cases among three consecutive years from 2016 to 2018. The peak in dengue positivity was observed during September to October. As this disease affects the population in the monsoon and post monsoon months therefore continuous monitoring of dengue infection is important during the post-monsoon season.


Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.


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