Nasal Trauma in Neonates receiving CPAP And its Prevention in tertiary care hospital.

JMS SKIMS ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 96-100 ◽  
Author(s):  
Mushtaq Ahmad Sheikh ◽  
Altaf Ahmad Bhat ◽  
Rukaya Akhthar ◽  
Mudassir Ahad Wani ◽  
Tariq Wani
Keyword(s):  
Tertiary Care ◽  
Maternity Hospital ◽  
Care Hospital ◽  
Medical College ◽  
Nasal Trauma ◽  
Group 2 ◽  
Neonatal Care Unit ◽  
Grade 3 ◽  
A Prospective Study ◽  
Group 1

Objectives: This study was done to evaluate the frequency and severity of nasal trauma secondary to nasal continuous positive airway pressure (NCPAP) in neonates and different methods to reduce the nasal septum injury via CPAP Methods: This is a prospective study carried out in the Neonatal Care Unit (NCU) of LAL DED maternity hospital associated with department of pediatrics Government Medical College, Srinagar, Kashmir. The study included newborns that underwent NCPAP with prongs on admission and those receiving NCPAP after weaning from ventilator, from 1st January 2016  - 1st jan 2017. Neonates noses were monitored from the first day of NCPAP treatment until its weaning. Nasal trauma was reported into Three Grades: (I) Erythema/pressure indentation (II) superficial Erosion and (III) Septal necrosis. Results:-258 newborns were included in study, 136 males and 122 females. All enrolled newborn received CPAP. Babies were randomly allocated to different groups in which no barrier and different barriers were applied. Randomization ofgroup of infants who received no barrier(group 0) and different barriers( group 1,2,&3) was done by systematic allocation, in which first newborn was randomly designated to no barrier group 0 on particular day of admission ,and subsequently alternating with other three groups i.e group 1,group 2, group 3. The mean gestational age, birth weight and CPAP days in each group is 31wk (GA28-35 wks),1200 gms(0.7kg-1.8kg) & 5 days(3-10days) respectively. Incidence of Septal  necrosis was 26.7% in the babies that had ‘No barrier applied at septal hudson prongs interface (Group0), which was significantly more (p<0.001) when compared with other three groups, within which its incidence was 2.8% in Cotton applied at septal and hudson prongs interface with glycerine (Group1), 7.1% in Danaplast applied at interface(Group2) and 0.0% in Cotton soaked with normal saline(Group3) respectively. In Group 0 nasal septal injury Grade 1 is (35%),grade 2 (35%),and grade 3(30.0%), in Group 1, grade 1 septal injury is (84%), grade 2(12.7%) & grade 3(2.8%),In Group 2 grade 1 is (65.7%),grade2(30.0%),grade3 (4.3%) and Group3 grade1(80.7%),grade2(19.3%) and Grade3 (0.0%) Conclusions: Nasal trauma is a frequent complication of NCPAP, especially in preterm babies and babies requiring nasal prongs for longer duration. And can be prevented by applying a barrier as in group 1,2 &3 in our study shows statistically significant decreased in severe nasal septal injury. JMS 2017;20(2):96-100  

scholarly journals Efficacy of Probiotic Saccharomyces boulardii as an Adjuvant Therapy in Acute Childhood Diarrhoea

2017 ◽  
Vol 36 (3) ◽  
pp. 250-255 ◽  
Author(s):  
Dillip Kumar Dash ◽  
Mrutunjaya Dash ◽  
M.D. Mohanty ◽  
Naresh Acharya
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Acute Diarrhoea ◽  
Oral Rehydration Therapy ◽  
Saccharomyces Boulardii ◽  
Care Hospital ◽  
Oral Rehydration ◽  
Group 2 ◽  
A Prospective Study ◽  
Group 1

Introduction: Administration of S. boulardii in addition to rehydration therapy in diarrhea found to be beneficial in many aspects owing to a variety of causes and importantly it is was not associated with any adverse effects.Material and Methods: We conducted a prospective study of children suffering from acute diarrhoea, at a private tertiary care hospital. Children were divided into 2 groups randomly as per odd(Group 1 ) and even (Group 2) bed allotted in indoor at the time of admission: Group 1 included children on oral rehydration therapy (ORT) + Zinc + Saccharomyces boulardii (Probiotic 5 billion CFU twice daily) and Group 2 comprised of children on ORT+ Zinc. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhoea.Results: Out of a total of 126 children less than 2 years, 2-6 years and 6-14 years were 72 (57.14%), 42(33.33%) and 12(09.52%) respectively. The duration of diarrhoea in Group 1 was 26.31 hours and Group 2 was 47.81 hours (p<0.01). The frequency of diarrhoea showed improvement within 24 and 72 hours in Group 1 and Group 2 respectively (p<0.01).Similarly, the mean duration of hospital stay was 2.68 days in Group 1 and 4.8 days in Group 2.The treatment cost was INR 850 and INR 1650 while social cost was INR 1250 and 2600 in Group 1 and 2 respectively.Conclusion:This study shows that S. boulardii reduced the duration, frequency and hospital stay of diarrhoea thereby reducing the treatment and social costs.J Nepal Paediatr Soc 2016;36(3):250-255

scholarly journals MRI Spectrum of Japanese Encephalitis in Northeast India: A Cross-Sectional Study

2021 ◽  
Vol 12 (02) ◽  
pp. 281-289
Author(s):  
Pranjal Phukan ◽  
Kalyan Sarma ◽  
Barun Kumar Sharma ◽  
Deb K. Boruah ◽  
Bidyut Bikash Gogoi ◽  
...  
Keyword(s):  
Japanese Encephalitis ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mri Findings ◽  
Mri Scan ◽  
Cross Sectional ◽  
Adc Value ◽  
Group 2 ◽  
Group 1

Abstract Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients (n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE (n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE (n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10–3 mm2/sec and group 2 JE had 1.095 ± 0.206 (SD) × 10–3 mm2/sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10–3 mm2/sec and adult JE was 0.982 ± 0.253 (SD) × 10–3 mm2/sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.

scholarly journals Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Before And After ◽  
A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

scholarly journals Comparison of placental grading at different periods of gestation in PIH patients and their outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4747
Author(s):  
Sneha S. ◽  
Sreelatha S. ◽  
Renuka Ramaiah
Keyword(s):  
Birth Weight ◽  
P Value ◽  
Medical College ◽  
Medical Disorders ◽  
Biophysical Profile ◽  
Significant Difference ◽  
Fetal Complications ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Background: The current study follows grannum grading of placenta. It is well known that there is accelerated placental maturation in PIH patients and the ultrasonic appearance of grade 3 placenta before 37 weeks may signify placental dysfunction and is associated with development of low birth weight babies, IUGR meconium stained liquor, low APGAR score. Hence this study was conducted to emphasize on placental grading at different periods of gestation to predict and prevent increased obstetric and fetal compromise and to compare the outcomes.Methods: Obstetric scans were performed in all PIH patients attending antenatal OPD and inpatients at ESIC and PGIMSR medical college, Bangalore to know the placental grading and biophysical profile. These women were followed till their delivery for obstetric and fetal outcomes.Results: Grade 3 placenta is seen in 17 patients in group 1(50%) and 39 patients (59%) in group 2. For statistical analysis grade 1 and 2 were combined and compared with  grade 3. P-value 0.198 which was not statistically significant. There was no statistically significant difference in age and gravidity between two groups. The medical disorders were more in group 2 i.e., between 37 - 40 weeks. The complications of PIH were also more in group 2. There were more number of LSCS (n=19 versus 14) in 34-36 weeks group which was not statistically significant. Fetal outcomes like IUGR and IUD were more in group 2 which was not statistically significant. The mean birth weight in group 1 was 2 kg as compared to 2.7 kg in group 2. All associated medical disorders were more in group 2.Conclusions: In hypertensive women there is accelerated placental maturation leading to maternal and fetal complications. Hence women with accelerated placental maturity in ultrasound should be closely monitored and appropriately managed. However, we recommend larger randomized studies are necessary.

scholarly journals Study of maternal and fetal outcome in antepartum eclampsia in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1108
Author(s):  
Aruna Rani R. ◽  
Dheeba Jayanthi R. ◽  
Eswari S.
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Obstetric Emergencies ◽  
One Year ◽  
A Prospective Study

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.

scholarly journals A PROSPECTIVE STUDY OF ADVERSE DRUG REACTIONS DUE TO PLATINUM ANALOGS - CHEMOTHERAPY IN A TERTIARY CARE HOSPITAL

2018 ◽  
Vol 11 (6) ◽  
pp. 215
Author(s):  
Sumit Kumar ◽  
Badruddeen Badruddeen ◽  
Singh S P ◽  
Mohammad Irfan Khan
Keyword(s):  
Adverse Drug Reactions ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Drug Reactions ◽  
Medical College ◽  
Health Organization ◽  
A Prospective Study ◽  
Platinum Analogs

Objective: The objective of this study was to analyze the types of adverse drug reactions (ADRs) associated with platinum analogs (cisplatin, carboplatin and oxaliplatin) used for cancer chemotherapy in a tertiary care hospital and determine their causal relationship with the offending drug.Methods: This prospective, observational, non-interventional study was conducted in a tertiary care hospital at GSVM Medical College Kanpur, India, for 4 months. Patients of all age and either sex were included in the study. ADRs were reported by the physicians of oncology department of the hospital and ADRs were assessed for different parameters -causality, outcome, and seriousness of ADR as per the World Health Organization (WHO), type of ADRs as per expanded Rawlins and Thompson’s classification, predictability using council for international organization of medical sciences guidelines and severity using modified Hartwig’s scale. Descriptive statistics were used for data analysis.Results: A total of 140 ADRs were reported from platinum analogs following treatment of different types of cancer in hospital. The burden of ADRs in each patient was 2.41. Most of the ADRs were observed in the age group of 40–60 years. Vomiting (27 ADRs) was commonly reported reaction. Among platinum analogs, cisplatin leads to 82 ADRs (58.57%) followed by carboplatin with 53 ADRs (37.86%) and least with oxaliplatin 5 ADRs (3.57%). Most of the ADRs on causality assessment were possible (104, 74.29%) and probable (36, 25.71%) in nature. Type -A ADRs account for 4/5th of the total reported ADRs, followed by Type-B and C. Severity of 90.71% ADRs was found to be mild followed by moderate, with no case of severe and serious nature. Nearly, most of the ADRs were of predictable type (97.14%).Conclusion: The potential of platinum analogs to cause ADRs is high; thus, the need of effective ADRs monitoring is highly emphasized.

scholarly journals Comparative study of Mirs’(Mushtaq and Shabir) technique of prepuce preserving minimally invasive urethroplasty with Snodgrass urethroplasty for repair of distal hypospadias without chordee…A prospective study

2015 ◽  
Vol 48 (01) ◽  
pp. 048-053
Author(s):  
Mushtaq Mir ◽  
Shabir Ahmad Mir ◽  
Muddassir Shahdhar ◽  
Mumtazdin Wani ◽  
Hakim Adil Moheen ◽  
...  
Keyword(s):  
Comparative Study ◽  
Tertiary Care ◽  
Care Hospital ◽  
Analgesic Requirement ◽  
Time Saving ◽  
Northern India ◽  
Significant Difference ◽  
Distal Hypospadias ◽  
Group 2 ◽  
Group 1

ABSTRACT Background: There is no single, universally applicable technique for hypospadias repair and numerous techniques have been practised from time to time. We compare the results of our new technique (Mirs’ technique also called Mush & Shab’s technique) to Snodgross urethroplasty. Mirs’ technique is a modified version of Thiersch-Duplay urethroplasty. Material and Methods: This prospective comparative study was carried out in a tertiary care hospital of Northern India over a period of 3 years from March 2010 to March 2013 and included 120 patients of anterior (distal penile, subcoronal, coronal and glanular) hypospadias without chordee. They underwent either Mirs’ technique (group 1 n = 60) or Snodgrass technique (group 2 n = 60). Follow-up was at 1-week, 1-month, 3 months and 6 months. Results: The mean operative time was 55 min (range: 43-70 min) in group 1 and 71.9 min (range: 60-81 min) in group 2 (P & 0.001). Urethrocutaneous fistula developed in two and four patients in group 1 and 2, respectively. Fistula closure was done at least 3 months postoperatively, and there was no significant difference in success rate between the two groups. Three cases of glanular dehiscence were detected (one in group 1 and two in group 2); the patient from group 1 had a successful repair using the already preserved prepuce. Conclusion: Mirs’ modification of Thiersch-Duplay technique for distal hypospadias is a time saving procedure with a lower overall complication rate. Valuable local tissue is preserved to deal with any complication that may occur. Analgesic requirement was significantly lower in this minimally traumatic technique. As it is less time consuming, simple and easy to learn with a short learning curve, this technique deserves application in cases of distal hypospadias.

scholarly journals Clinical profile of snake bite patients in tertiary care hospital in Himachal Pradesh: a prospective study

2018 ◽  
Vol 6 (7) ◽  
pp. 2444 ◽  
Author(s):  
Madan Kaushik ◽  
Vikas Banyal ◽  
Sachin Sondhi ◽  
Manish K. Thakur ◽  
Aseem Kaushik
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Himachal Pradesh ◽  
Snake Bite ◽  
Clinical Profile ◽  
Care Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Gandhi Medical College ◽  
A Prospective Study

Background: To study clinical profile of snake bite patients in tertiary care hospital in Indra Gandhi Medical College at Shimla, Himachal Pradesh of North India.Methods: Hospital based prospective observational study was conducted in the Department of Medicine, for the duration of one year from 1st June2013 to 31st May 2014.Results: A total of 78 patients were admitted with mean age of 38.46 years with male to female ratio of 1:1.6. Seasonal variation with peak incidence during rainy season was seen. Most common snake identified was green coloured and peak timing of snake bite was between 07:00am-04:00pm. There was delay in admission of more than 6 hours in 66.67% of cases. Hemotoxicity was predominant manifestation seen in 62.82% of cases and persistence of coagulopathy was most common complication (51.02%) despite giving optimal ASV. There was paucity in ASV administration seen in only 59.46% of referred patients. Mean ASV vials used were 23.41 vials ±8.72 vials.Conclusions: Mass education is required at both general population and health professional levels to improve snake bite management and monovalent ASV against Green pit viper is more practical option to manage cases in this region.

scholarly journals Rationale in management of entero-cutaneous fistula following routine and emergency surgery: a prospective study in a tertiary care hospital of Odisha

2018 ◽  
Vol 5 (12) ◽  
pp. 4000
Author(s):  
Jagmohan Mishra ◽  
Afroza Firodous ◽  
Biplab Mishra
Keyword(s):  
Gastrointestinal Tract ◽  
Emergency Surgery ◽  
Surgical Complication ◽  
Enterocutaneous Fistula ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical College ◽  
Surgical Nutrition ◽  
Enteric Perforation ◽  
A Prospective Study

Background: The enterocutaneous fistula is an abnormal communication between gastrointestinal tract and skin. It is a grave surgical complication following surgery on gastrointestinal tract. Despite in surgical nutrition and critical care, mortality from enterocutaneous fistula remains high. Improvements in outcome are focused on prevention and when fistula occurs, prompt recognition and intervention is essential.Methods: This is institutional based prospective observational study which was conducted in S.C.B Medical college, Cuttack, Odisha for a period from September 2015 to September 2017 on 30 patients with enterocutaneous fistulae occurring as post-operative complication among patients admitted and operated at our institution for various gastrointestinal conditions and also referred from other centres after complication had set in. Detailed history, physical examination, routine workup, management and its outcome were studied.Results: The maximum number of fistulae (86.7%) developed after emergency surgery than routine. Incidence of enterocutaneous fistulae was observed in cases operated for intestinal obstruction (40%) followed by operation for enteric perforation (28%). The highest incidence of enterocutaneous fistula occurred on 8th post-operative day (36.7%). 24 cases were treated conservatively while 6 patients underwent operative treatment.Conclusions: Hence, the enterocutaneous fistula is frequently seen with emergency surgery of gastrointestinal tract, particularly on ileum, usually occurring around 8th post-operative day and most of them end in spontaneous closure with conservative treatment.

Sign in / Sign up

Export Citation Format

Share Document