ORAL IRON VERSUS PARENTERAL IRON SUCROSE IN A RURAL TERTIARY CARE HOSPITAL OF SOUTHERN INDIA

2021 ◽  
pp. 48-50
Author(s):  
Ravindra S Pukale ◽  
Kavyashree H B
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cell Mass ◽  
Medical Science ◽  
Oral Iron ◽  
Iron Sucrose ◽  
P Value ◽  
Care Hospital ◽  
Study Results ◽  
Group B

Introduction: Nutritional iron deciency is one of the most common deciency disorders affecting more than one billion people, with pregnant women at particular risk. In pregnancy iron decit attributable due to increased iron demand of the feto-placental unit and an increase in maternal red cell mass. 30% of anaemic women have haemoglobin levels below 10g/dl above 10% below 8g/dl. Irrespective of mode of delivery blood loss can also be a contributing factor postnatal. Oral iron therapy and intravenous iron sucrose are the main therapy of iron deciency anaemia. The present study is aimed at comparing both their efcacy side effects. METHOD : Aprospective randomised control study was done from June 2019- September 2020, in the department of Obstetrics and gynaecology, Adichunchanagiri Institute of Medical Science, BG nagara. 253 women including antenatal women between 8-38 weeks gestational age were studied and postnatal women studied with no associated obstetrics and medical complication. They were divided into Group A (Oral) and Group B(Intravenous) by randomization. The two groups were monitored clinically, and for an improvement in laboratory parameters after four weeks on day 30 haemoglobin and haematocrit were repeated in both the groups. This study results were expressed as mean +/- standard deviation. And to test the signicance of difference between Oral and IVmode of treatment, student Ttest was done to verify the statistical signicance. RESULTS: Out of 253 patients in the study the mean age of ANC patients was 24.7+/- 4.4years. Mean age of PNC patients was 24.15+/- 3.5years. The peripheral smear showed Dimorphic anaemia in 9.1% and Microcytic Hypochromic picture in 90.9 % of the patients. Initial haemoglobin of ANC patients was 9.8+/- 0.3g/dl. The initial haemoglobin of PNC patients was 9.73+/- 0.91g/dl. 59.3% of the patient had a haemoglobin between 7.1 and 10.0g/dl. Final haemoglobin of an ANC patient was 11.68+/-0.98g/dl, PNC patients 11.69+/-0.99g/dl. There was a substantial increase in Group Ahaemoglobin (oral iron) raising from 10.2+/-7.2g/dl to 12.0+/-0.92g/dl with a T value of 9.25. as well as in Group B (iron sucrose) raising from 9.3+/-8.5g/dl to 11.3+/-0g/dl with T value of 5.65. In both cases this raise in haemoglobin after four weeks had a p value less than 0.01 which was highly statistically signicant. Conclusion:Intravenous iron sucrose is more effective than oral iron for correction of anaemia with lesser side-effect

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

scholarly journals EFFICACY AND TOLERABILITY OF FLUPIRTINE VERSUS TRAMADOL IN THE TREATMENT OF MODERATE CHRONIC LOW BACK PAIN

2019 ◽  
pp. 84-87
Author(s):  
VINEELA KARTHIK NAGURI ◽  
RAVI BABU KOMARAM ◽  
TAMILISETTI VIDYA SAGAR
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Low Back ◽  
Drug Reactions ◽  
Study Results ◽  
Group A ◽  
Group B

Objective: The objective of the study was to assess and compare the efficacy and tolerability of flupirtine versus tramadol in patients with chronic moderate low back pain (LBP). Materials and Methods: A prospective study was conducted in the outpatient department of orthopaedics at tertiary care hospital, Rajamahendravarm. After meeting the inclusion criteria, a total of 60 patients were randomly allocated to tablet flupirtine 100 mg in Group A and tablet tramadol 50 mg in Group B. The efficacy of the study drugs was assessed at baseline and the end of treatment by numerical rating scale11, visual analog scale-100 mm, physician’s, and patient’s global assessment. Statistical analysis was done using paired and unpaired t-test and data were presented as mean±standard deviation. Adverse drug reactions were monitored during the treatment. Results: The study results showed that 90% of the patients in Group A and 78% of the patients in Group B had shown a good response to their respective drugs. 30% of flupirtine group patients reported adverse drug reactions which were mild. Conclusion: Both the drugs are effective in the treatment of moderate chronic LBP, but the advantage of flupirtine was, the incidence of adverse drug reactions was less when compared to tramadol group.

scholarly journals THE PHARMACOECONOMIC IMPACT OF GASTRO-PROTECTIVE AGENTS AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 92-96
Author(s):  
NIRUPAMA KULKARNI ◽  
MOPIDEVI RASI ◽  
NAZARIYA NIZAR ◽  
NISHOJA DAVID ◽  
PRASAD N BALI ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Cost Benefit Analysis ◽  
Tertiary Care ◽  
Medical Science ◽  
Cost Effective ◽  
Care Hospital ◽  
Statistical Tool ◽  
Protective Agents ◽  
Cost Effective Treatment ◽  
Study Results

Objectives: The study aimed to evaluate the pharmacoeconomic impact of gastro-protective agents (GPA) by carrying out cost-benefit analysis (CBA) and cost-effective analysis (CEA). Methods: This prospective observational study was carried out by simple randomization technique at Karnataka Institute of Medical Science, Hubballi. Data used were socio-economic details based on modified B. G Prasad scale. Current Index of Medical Specialists updated version March 2021 was used for CBA and CEA. Regression analysis was the statistical tool used in the study. Results: A total of 120 participants were included in the study. 57.5% were male and 42.5% were female. 3.33% were pediatrics, 32.5% were young adults, 37.5% were elder adults and 26.67% were geriatrics. Out of 120 samples, 94 participants were prescribed with pantoprazole, other drugs prescribed include domperidone and pantoprazole, rabeprazole, and ranitidine. The CBA revealed ratio of benefits over costs for pantoprazole was 3.86, ranitidine was 9.31, pantoprazole and domperidone was 0.84 and rabeprazole was 0.84. Additional cost of 138.30 Indian Rupee must be spent on pantoprazole over ranitidine to get cost-effective treatment without disease for one whole year. Conclusion: The CBA revealed that maximum patients received benefits for pantoprazole. CEA gives an idea on best effective treatment over two drugs of different class. Our study concludes that pantoprazole is deemed to be superior over other drugs of GPA prescribed among study participants.

scholarly journals BREASTFEEDING TEMPORAL DISTRIBUTION TRENDS AMONG NEONATES IN TERTIARY CARE HOSPITAL IN LAHORE

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Hamid Mehmood ◽  
Zarmast Khan ◽  
Abdul Rauf ◽  
Ammara Waqar
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Temporal Distribution ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Significant Difference ◽  
Initiation Of Breastfeeding

ABSTRACT  BACKGROUND & OBJECTIVE: Breastfeeding provides immunity against bacterial, viral, and other infectious diseases. More than four million new neonates die due to vaccine-related diseases in the first 28 days of their lives. It is therefore emphasized that breastfeeding in the first hours after delivery may save the neonate. The objective of this study was to determine the factors affecting the pattern of breastfeeding among the neonates and assess the frequency of early breastfeeding among neonates at Gulab Devi Hospital, Lahore. METHODOLOGY: It was a cross-sectional descriptive study. One hundred mothers were selected through convenient purposes sampling. Chi-square test applied for an association between mode of delivery and initiation of breastfeeding. RESULTS: The result of the study showed variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery. Pre-lacteal was given to 59 mothers, while 41 were not given with any pre-lacteal. A significant association was found between mode of delivery and initiation of breastfeeding with a p-value less than 0.001 CONCLUSION: The result of the study showed that variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery provided a significant difference in the production of the neonate in the first 28 days.

ACCEPTANCE, COMPLICATION, EXPULSION AND FAILURE RATE OF POSTPARTUM IUCD IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 44-46
Author(s):  
Sumit Ranjan Pramanick ◽  
Saumen Mandal ◽  
Bharat Chandra Mandi ◽  
Debarshi Jana
Keyword(s):  
Family Planning ◽  
Population Policy ◽  
Post Partum ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Expulsion Rate ◽  
Study Results ◽  
The World

Introduction: 1 India's population has crossed one billion in the year 2000. In recent censes of 2011 it has reached 121 crores and it is estimated to 2 reach a gure of1.53 billion by 2050, making it the most populous country in the world . India is the rst country in the world to adopt an ofcial population policy and launch ofcial family planning programme way back in 1952, which remains the mainstay of family planning efforts. Aims and objectives: 1. To nd out the proportion of accepting the Post-Partum Intrauterine Contraceptive Device (PPIUCD) insertion among eligible women delivering at SSKM hospital. 2. To assess the complications of post placental &intra caesarean PPIUCD if any among these acceptors. 3. To determine the spontaneous expulsion rate of this contraceptive device. Materials and methods: All Adult ANC women attending SSKM hospital at Gynae OPD and as well as admitted in hospital wards or Labour Room who will full the inclusion criteria during data collection period. Conclusion: The study results, it can be concluded that PPIUCD in the eld of PPFP is a promising approach. Whatever may be the mode of delivery, PPIUCD is safe and efcacious in terms of safety and efcacy.

scholarly journals Morbidity Pattern and Hospital Outcome of Neonates Admitted in Tertiary Care Hospital, Nepal

2020 ◽  
Vol 40 (2) ◽  
pp. 107-113
Author(s):  
Deepeshwara Nepal ◽  
Sumit Agrawal ◽  
Sushan Shrestha ◽  
Ajit Rayamajhi
Keyword(s):  
Birth Weight ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Extremely Low Birth Weight ◽  
P Value ◽  
Care Hospital ◽  
Hospital Outcome ◽  
Poor Outcome

Introduction: The first 28 days of life, neonatal period is crucial as neonates are susceptible to sepsis, birth asphyxia, hypoxic injuries and its consequences which may lead to lifelong morbidity. Knowing the causes of morbidity and mortality is an essential step to improve neonatal health. The aim of this study is to describe the pattern and causes of neonatal admission, immediate hospital outcome in the form of improved, died or left against medical advice  and factors associated with its outcome. Methods: This was a retrospective hospital based study carried out in Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital, Kathmandu, Nepal over a period of six months (February 2019 to July 2019 AD). Neonatal details including age, sex, gestational age, birth weight, and maternal age and parity, mode of delivery, place of delivery, neonatal morbidities and neonatal outcomes were recorded in a predesigned performa. Results were expressed as mean, percentage and p value. P- value was calculated by using chi-square test. Results: A total of 163 neonates were admitted during the study period, among which 106 (65%) were males. The mean birth weight was 2483.96 ± 812.63 gm. Among admitted newborns 130 (79.8%) had good outcome, babies born to young mothers (< 20 years of age) had poor outcome which is statistically significant with p value of 0.002. Neonates whose birth weight were < 1000 gram had significantly poor outcome (0.001). Conclusion: Common causes of NICU admission were neonatal sepsis, neonatal hyperbilirubinemia, prematurity and perinatal asphyxia. Babies born to young primipara mothers, extremely low birth weight, extremely premature babies and babies undergoing mechanical ventilation had poor outcome.

scholarly journals Diagnostic laparoscopy in acute abdominal pain

2019 ◽  
Vol 6 (4) ◽  
pp. 1104
Author(s):  
Ravichandran Subramaniam
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Diagnostic Laparoscopy ◽  
Acute Abdominal Pain ◽  
Tertiary Care ◽  
Medical Science ◽  
Ovarian Torsion ◽  
Care Hospital ◽  
Number Of Patients ◽  
Study Results

Background: Acute Abdominal pain is an important surgical problem in all age groups. Early diagnosis is needed to rule out life threatening conditions. Diagnostic laparoscopy is a modern useful tool in giving proper treatment for all needed individuals. The aim of the present endeavor is to study the use of laparoscope in patients with acute pain over the abdomen, to diagnose and confirm conditions like acute appendicitis, appendicular abscess, doudenal perforation, ileal perforation. Ovarian torsion. mass formation, etc. where clinical and imaging studies are inconclusive.Methods: This study was conducted in the tertiary care hospital and the Department of General Surgery, Melmaruvathur Adhiparasakthi Institute of Medical Science and Research, Melmaruvathur. The period of study was from June 2017 to May 2018. All patients coming to the hospital with acute abdominal pain in the age group of ten years to seventy years were included in this study. Results: Majority of the patients had the findings relevant to the correct clinical diagnosis. However significant number of patients had unexpected findings and so the diagnosis was changed, and treatment also changed. Total 100 patients were included in this prospective study. 79 patients were found to have acute appendicitis. Duodenal perforation seen in 7 patients. Jejunal perforation seen in 2 patients. Mesenteric ischemia seen in 1 patient. Acute cholecystitis seen in 3 patients. Gall bladder perforation seen in 1 patient. Ectopic pregnancy was seen in 2 patients. Ovarian torsion seen in 3 patients. Ileocecal tuberculosis seen in 1 patient. No abnormality seen in 1 patient.Conclusions: The best approach in abdominal pain is to do diagnostic laparoscopy and proceed, rather than going for open laparotomy. Diagnostic laparoscopy gives all benefits of minimal invasive surgery. Not much of pain, shorter period of hospitalization, small scars, low infection rates and most importantly, accurate diagnosis and the correct treatment of most of the intra-abdominal conditions are the gifted things.

scholarly journals Fetomaternal outcome following labour induction in oligohydramnios and borderline liquor: a retrospective study in a tertiary care hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 4615
Author(s):  
Jyothi Susan Thomas ◽  
Mary Daniel ◽  
Sangeetha Selvaraj
Keyword(s):  
Retrospective Study ◽  
Amniotic Fluid ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Morbidity And Mortality ◽  
Labour Induction ◽  
P Value ◽  
Care Hospital ◽  
Parametric Data

Background: Amniotic fluid provides a protective milieu for the growing fetus in pregnancy and labour. A decrease in the amniotic fluid volume has been associated with increased maternal morbidity and fetal morbidity and mortality. The purpose was to compare the effect of labour induction on the fetomaternal outcome in women with oligohydramnios, borderline liquor and normal liquor at term.Methods: A retrospective study of all the labour induction in women with oligohydramnios, borderline liquor and normal liquor volume at 37-42 weeks gestation in a tertiary care teaching hospital. The demographic characteristics, maternal outcomes like mode of delivery, indication for operative delivery, meconium stained liquor and perinatal outcomes were compared in between the three groups. Parametric data was compared by chi-square test and non-parametric data by students’-test. A p-value less than 0.05 was taken as significant.Results: Among the 2338 deliveries during the study period, labour was induced in 266 women (11.3%). Out of which, 109 cases (40.9%) in oligohydramnios group, 111cases (41.7%) in borderline liquor group and 46 cases in normal liquor group. The incidence of meconium stained liquor, the number of operative deliveries and fetal distress was significantly higher and significantly lower birth weight (<2.5 kg) in the group with oligohydramnios and borderline liquor (p <0.05). Low Apgar score and admission to neonatal intensive care unit was higher in the oligohydramnios group (p<0.05).Conclusions: Induction of labour on detecting borderline liquor at term may help in reduction of maternal and fetal morbidity and mortality.

scholarly journals ROLE OF OCTREOTIDE ON OUTCOME OF PATIENTS WITH ACUTE PANCREATITIS

1969 ◽  
Vol 5 (1) ◽  
pp. 639-643
Author(s):  
AJMAL KHAN ◽  
SAMIULLAH ◽  
MANZOOR ALI ◽  
SAIFUREHMAN
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Pain Control ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
P Values ◽  
Group A ◽  
Group B

BACKGROUND: acute pancreatitis is a multisystem disease carrying broad spectrum of clinicalpresentation and complications. The objective of this study was to determine the positive role ofoctreotide in the out come of patients suffering from acute pancreatitis.OBJECTIVE: The objective of this study was to assess the role of octreotide in patients having acutepancreatitis.PATIENTS AND METHODS: This is a descriptive, comparative, prospective study. The study wasconducted in the department of surgery Saidu Group of Teaching hospital Saidu Sharif Swat fromJanuary 2011 to June 2014. Total of seventy consecutive patients having acute pancreatitis wasrandomized in a prospective trail for the treatment, at tertiary care hospital in Malakand division SwatKPK Pakistan. The data of patients were recorded on a purposely prepared proforma for this study. Thediagnosis of patients was established on basis of biochemical (serum amylase, WCC, C-reactive protein)and radiological (USG, CT- scan) investigations. The patients were divided into two groups, A and B.Group A, had received octreotide along with fluids, omeprazole, analgesic. Group B received fluids,omeprazole, analgesic without octreotide. Ages of the Group A and B were matched (±5 years). Datawas analyzed using SPSS version 16 employing chi-square test (X" test). A p-value below 0.05 wasconsidered statistically significant.RESULTS: In this prospective, comparative study two groups, each of 35 consecutive patients wereselected. The mean age in Group A was 37 ±12.41 years and in Group B 40±10.32 years (p DO.364).There were 12 males and 23 females in group A, while 14 males and 21 females in group B. Both thegroups were comparable. All the patients in octreotide group A and non-octreotide group B weresurvived. No major complications were noted in either group. As far as mean hospital stay was 7 ±2.10days in group A, while it was 9±3.14 days in group B (p<0.032). All the P- values for the criteria ofstudy were calculated. P-values were significant when we consider pain control and hospital stay intwo groups.CONCLUSION: In our study we found that octreotide was more effective in the final outcome ofpatients with acute pancreatitis. There is clear cut beneficial effect of octreotide on hospital stay andreduced need of analgesics in patients having acute pancreatitis.KEYWORDS: Acute Pancreatitis, Octreotide, Hospital Stay, pain control.

scholarly journals Comparative analysis of postpartum IUDC versus interval IUCD insertion: a study conducted in a tertiary care hospital in Karachi, Pakistan

2020 ◽  
Vol 8 (6) ◽  
pp. 2213
Author(s):  
Zakia Bano ◽  
Sanober Memon ◽  
Fiza Ali Khan ◽  
Mala Jitendra Shahani ◽  
Urooj Naz ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Hemoglobin Level ◽  
P Value ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Continuous Variables ◽  
Group A ◽  
Group B ◽  
Baseline Hemoglobin

Background: To compare the effectiveness of postpartum intrauterine contraceptive device (PPIUCD) with interval IUCD in terms of effectiveness, expulsions, bleeding pain and other complications at Tertiary care Hospital.Methods: Current study was conducted among 224 women, at Gynaecology and Obstetrics of Reproductive Health Services-A (RHS-A) Centre of Jinnah Post Graduate Medical center, Karachi, for a period of Six months. Approval from Ethical committee and informed consent was taken from women and her husband before starting the study. The WHO medical eligibility criteria for contraceptive use (MEC) were followed and IUCD was inserted in 112 women in PPIUCD group and in 112 women in interval IUCD group. These cases were followed at 15 days, 6 weeks and 6 months. Results of PPIUCD group were compared with interval IUCDs group. Data was analyzed by using SPSS version 18.0. Continuous variables like age, parity, hemoglobin level were analyzed as mean±standard deviation. Frequencies and percentages were calculated for infection, expulsion, bleeding per vagina and effectiveness. Chi-square was applied to assess the difference between the categories. p value <0.05 was taken as significant.Results: The two groups were identical in mean ± SD age, parity, residence and baseline hemoglobin level. PPIUCD (Group-A) was more effective i.e., 87.5% as compared to interval IUCD (Group-B) i.e., 83.9%. Pain, PID, bleeding and expulsion of IUCD were more prevalent with interval IUCD (Group-B) than PPIUCD (Group-A) patients. Stratified analysis showed that age, parity & mean baseline hemoglobin were non-significant effect modifiers on the effectiveness among the two groups.Conclusions: Postpartum IUCD use was found to be a safe, simple, inexpensive and reversible procedure with higher chances of retention for a longer period. Additionally, there is decreased risk of complications and lower expulsion rates when compared with interval IUCD.

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