Management and Outcome of Postoperative Complications among the Patients Undergoing Common Obstetric and Gynaecological Surgery outside the RMCH

2018 ◽  
Vol 30 (2) ◽  
pp. 7-12
Author(s):  
Mosammat Nargis Shamima ◽  
Rubayet Zereen ◽  
Nargis Zahan ◽  
Most Rowshan Ara Khatun ◽  
Nurjahan Akter ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Public Hospitals ◽  
Medical College Hospital ◽  
Obstetrics And Gynecology ◽  
Tertiary Referral Hospital ◽  
College Hospital ◽  
Medical College ◽  
District Hospitals ◽  
Operative Complications ◽  
Post Operative Complications

Objective: To review the management and outcome of postoperative complications after common obstetric and gynecologic surgeries performed in outside nonacademic private hospitals (clinics) and peripheral public hospitals (districts hospitals) and later admitted in Department of Obstetrics and Gynecology of Rajshahi Medical College Hospital (RMCH). RMCH is a tertiary referral hospital where all complicated patients were referred for better management from surrounding hospital.Methodology: This Quasi-experimental study was carried out in the Department of Obstetrics and Gynecology at Rajshahi Medical College Hospital, Rajshahi, Bangladesh between July 1, 2015 and June 30, 2017. All patients admitted with post operative complications following common obstetric and gynecologic surgeries during this period were included. Patients admitted with post operative complications, where primary surgery was done in this hospital were excluded. The common obstetric and gynaecological surgeries were caesarean sections (LUCS), total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH) performed outside Rajshahi Medical College Hospital.Result: During this period a total of 39,929 patients were admitted through emergency way in obstetrics and gynecology department of Rajshahi Medical College Hospital. Among them 675 patients were admitted with the complaints of post operative complications following common obstetric and gynecologic surgeries with rate being 1.7%. In 560(83%) cases surgery was done in clinics and 115(17%) cases surgery was done in district hospitals. Among the patients 580(85.9%) cases primary operation was done by non-gynaecologic surgeon and 95(14.1%) cases by gynaecologic surgeon. Caesarean section was the primary obstetric surgery in 405(60%) cases .Gynecologic surgeries included TAH in 185(27.4%) cases and VH in 85(12.6%) cases. We found 25(3.7%) patients died from these complications. Repeat surgery was done in 90(13.33%) cases. Genitourinary fistula repair was done in 41 cases (45.55%). Rests were improved by conservative management.Conclusion: Any surgical procedure carries risk of complications. Careful selection of patients with suitable indications for operations, expertise of the surgeon, good surgical technique, proper knowledge of pelvic anatomy and careful postoperative follow up can minimize recognized complications.TAJ 2017; 30(2): 7-12

scholarly journals Determinants of near miss mortality in a tertiary care centre

2017 ◽  
Vol 6 (2) ◽  
pp. 470
Author(s):  
Sofia Abubekhar Suhurban ◽  
Sujatha Thankappan Lekshmikutty ◽  
Mayadevi Brahmanandan ◽  
Sreekumary Radha
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
High Body Mass Index ◽  
Medical College Hospital ◽  
Major Determinant ◽  
Near Miss ◽  
Obstetrics And Gynecology ◽  
Main Role ◽  
College Hospital ◽  
Medical College

Background: Near misses are defined as pregnant women with severe-life threatening conditions who nearly die but, with good care or good luck survive. Because near miss situation occurs more frequently than maternal death, more comprehensive and statistically reliable analysis could be conducted to assess the quality of maternal care and to develop evidence-based management protocols. The objectives of this study were to evaluate the determinants of near miss maternal mortality in a tertiary referral Government medical college hospital in Trivandrum, Kerala.Methods: Case control study from a defined delivery population with three randomly selected pregnant women as controls for every case. Study was conducted at Department of Obstetrics and Gynecology, Medical College Hospital Trivandrum, Kerala, India. Study duration was one year. Study population were patients admitted in Obstetrics and Gynecology Department, fulfilling the WHO criteria of near miss.Results: Of the primary determinant factors of near miss in this study, preeclampsia contributed the main role, followed by hemorrhage and eclampsia. During the antenatal period, preeclampsia was the major determinant followed by eclampsia. Hemorrhage was the major determinant in intra op /intra natal cases and next was eclampsia. Postpartum hemorrhage, eclampsia and preeclampsia were the major determinants in post-partum /post op cases. Among the associated indicators assessed, low socioeconomic status, anaemia, high body mass index, referral status, placenta praevia and caesarean section were statistically significant.Conclusions: Detailed analysis of near miss cases helps in identifying risk factors. It helps in formulating preventive strategies, and helps us in tackling the delays in referral process.

scholarly journals Institutional and population based analyses on misdiagnosis of appendicitis in Khulna, Bangladesh

Mediscope ◽  
2017 ◽  
Vol 4 (2) ◽  
pp. 29-34
Author(s):  
BK Basu ◽  
MM Rashid ◽  
MS Laskar ◽  
MT Islam
Keyword(s):  
Postoperative Complications ◽  
Population Based ◽  
Medical College Hospital ◽  
Chronic Cystitis ◽  
College Hospital ◽  
Factors Associated ◽  
Medical College ◽  
Group 2 ◽  
Group 1 ◽  
Patient Department

The aim of the present study was to identify factors associated with misdiagnosis of appendicitis to propose solutions to decrease the misdiagnosis rate of appendicitis. The study conducted an institutional and a population based analyses on misdiagnosis of appendicitis conducted in Khulna district, Bangladesh. The study dealt with 2 groups of patients. Group 1 consisted of the patients treated in Gazi Medical College Hospital (GMCH), Khulna either in out-patient department (OPD) within the last 3 years (from 2014 to 2016), treating doctors suggested appendicectomy and in indoor-patient department (IPD) within the last 5 years (from 2012 to 2016), the diagnosis was done either during operation or admitted as postoperative complications. Patients for Group 2 were selected purposively from the patients who were from different villages of Rupsha and Fakirhat Upazila or from Khulna city previously underwent appendicectomy within the last 5 years (from 2012 to 2016) in different hospitals other than GMCH, Khulna and previous symptoms were still existed. The study revealed that the majority of the patients were female (OPD 81.5%, IPD 68.8% in Group 1 and 83.2% in Group 2). The misdiagnosis rate of appendicitis for the patients attended GMCH OPD and GMCH IPD was 23.0% and 8.9%, respectfully. The overall misdiagnosis rate of appendicitis for the patients attended GMCH was 14.0%. In case of the patients attended GMCH OPD, most of them had UTI and chronic cystitis (45.5%). In case of the patients attended GMCH IPD, most of them had non-inflamed appendix (84.4%). The misdiagnosis rate of appendicitis for the patients in Group 2 was 23.2%. Some factors were identified and bearing in mind the factors, all the concerned should be more careful and conscious while making the diagnosis of appendicitis to avoid misdiagnosis and patients’ suffering.Mediscope Vol. 4, No. 2: Jul 2017, Page 29-34

scholarly journals Relaparotomy in Obstetrics and Gynaecology Department of Faridpur Medical College Hospital - Experience in One Year

2013 ◽  
Vol 7 (2) ◽  
pp. 75-78
Author(s):  
Irin Parveen Alam ◽  
Dr. Mahbuba ◽  
Shila Rani Das
Keyword(s):  
Rectus Sheath ◽  
Cross Sectional Study ◽  
Study Data ◽  
Medical College Hospital ◽  
Tertiary Referral Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Retained Foreign Body ◽  
Obstetrics And Gynaecology

After abdominal surgery some patient's needs relaparotomy for complications developed postoperatively. Aim of this study was to determine the risk factors causing re-laparotomy, the indications, management and outcomes of relaparotomy admitting in Obstetrics and Gynaecology department in Faridpur Medical College Hospital, a tertiary  referral hospital where all complicated patients are referred for management from surrounding districts hospital. It  was a cross sectional study done during the period of January 2011 to December 2011, All the cases among which relaparotomy were done after primary surgery were recorded using a protocol prepared for the study. Data was analyzed. Total 6304 patients were admitted in emergency way in Obstetrics and Gynaecology department of Faridpur Medical College Hospital. Among them 1864 patients undergone emergency operations, here 15 patients  needed re-laparotomy. The incidence of re-laparotomy was 0.80%. Indications of relaparotomy included internal hemorrhage, postpartum hemorrhage (PPH), retained foreign body, incorrect diagnosis at first laparotomy, intraabdominal collection of pus and urine, Rectus sheath haematoma and burst abdomen. Often more than one procedure  was needed to manage the cases. Re-laparotomy causes much morbidity & mortality with increase in hospital stay  and cost. Careful selection of cases for primary operation, expertise of the surgeon, good surgical technique and  careful postoperative follow-up can reduce the need for re-laparotomy. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13503 Faridpur Med. Coll. J. 2012;7(2):75-78

Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani
Keyword(s):  
Postoperative Complications ◽  
Pelvic Osteotomy ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Canal Width ◽  
Operative Complications ◽  
Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

Histopathological study of prostatic lesions in a medical college hospital

2020 ◽  
Vol 3 (3) ◽  
pp. 234-237
Author(s):  
Dr. Avinash Priyadarshi ◽  
Dr. Debi Prosad Dasgupta ◽  
Dr. Ajay Kumar
Keyword(s):  
Medical College Hospital ◽  
Histopathological Study ◽  
College Hospital ◽  
Medical College
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