IMPACT OF GOVERNMENT SCHEMES ON MATERNAL HEALTH: AN OBSERVATIONAL STUDY IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

2021 ◽  
pp. 63-65
Author(s):  
Neena Gupta ◽  
Uruj Jahan ◽  
Subhashini Singh

BACKGROUND: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. For reduction of maternal mortality and morbidity Government of India launched National health mission (NHM). Some of the major initiatives under NHM are– ASHA (Accredited Social Health Activist), JSY/JSSK (Janani Suraksha Yojana / Janani Shishu Suraksha Karyakaram), National mobile medical units, National ambulance services. METHODS: A retrospective observational study was performed in department of Obstetrics and Gynaecology, G.S.V.M Medical College, Kanpur, Uttar Pradesh which is a low performing state, during the period of 2018 to 2019. A total of 5134 obstetric patients including 1032 low general condition patients were included over duration of 20 months since January 2018 to august 2019. This observational study collected information regarding number of deliveries in different years in this tertiary care hospital, effect on availability of health facilities and antenatal care to the antenatal women after introduction of JSY, ASHA and ambulance services. CONCLUSIONS: After JSY there is major difference in OPD admission and institutional delivery rate. Ambulance services had major contributory role in reducing maternal mortality and morbidity. There is need to improve performance of ASHA by proper supervision and monitoring.

Author(s):  
Surbhi Gupta ◽  
Anju Shukla ◽  
Poonam Singh ◽  
Areena H. Siddiqui

Background: Nucleic acid amplification test (NAAT) is considered gold standard in the molecular diagnosis of CoV-2 infection but since it is costly, labor intensive and needs technical expertise, rapid chromatographic immunoassay for the qualitative detection of specific antigens to SARS CoV-2 have been devised. Objectives of this study was to compare the results of Antigen test and NAAT for CoV-2 infection carried out during the months of July and August 2020 by single tertiary care hospital in Lucknow, Uttar Pradesh and to determine the utility of rapid antigen test in the SARS CoV-2 diagnosis.Methods: All the patients who came to our hospital seeking admission during July 2020 and August 2020 were included in the study. A total of 1000 patients were included in this study.Results: Out of a total 1000 cases which were included in the study, 769 cases (76.9%) were found to be SARS CoV-2 negative by both antigen and CBNAAT, 100 cases (10.0%) were SARS CoV-2 positive by both antigen and CBNAAT tests. But in 131 cases (13.1%), antigen was not able to pick up the disease. It was also found that the Cycle Threshold (Ct) value for the discordant group was higher (Mean E= 28, Mean N2=33) when compared to the group where antigen was positive.Conclusions: The present study establishes the role of rapid antigen tests in contributing to the quick, point of care diagnosis of SARS CoV-2. These assays are safe, simple, and fast and can be used in local clinics and hospitals. These tests are very important for real-time patient management and infection control decision.


Author(s):  
Shazia Zargar ◽  
Nikita Gandotra

Background: The uncontrolled wave of cesarean rates has increased globally which has resulted in a significant amount of maternal mortality and morbidity. The present study aims to evaluate the trend in cesarean section rates in Jammu, India. Methods: The present retrospective study was carried out at the department of Obstetrics and Gynecology, SMGS Hospital, Jammu, India. We collected data based on total number of deliveries and cesarean sections performed at the hospital during (March2015-Feb2020) along with indications for CS.Results: The percentage of cesarean sections has increased drastically from 39.4% during (2015-16) to 49.9% in (2019-20). The study shows that the most common indication for CS is post CS followed by NPOL, Fetal distress, breech, APH, CPD, PIH and others.Conclusions: There is a growing concern among public and health care providers regarding the escalating and uncontrolled trend of cesarean sections which needs to be curtailed within optimal limits recommended by WHO. 


2020 ◽  
Vol 27 (05) ◽  
pp. 1085-1088
Author(s):  
Ikram Ali ◽  
Muhammad Kashif ◽  
Muhammad Owais Aziz ◽  
Haider Darain

Pakistan is striving hard to achieve millennial developmental goals by considering multiple factors. However, maternal mortality and morbidity due to medical errors remain unnoticed and undocumented due to lack of reporting system. This case report is based on a multigravida, who presented with severe abdominal pain and tenderness. She was on multiple medications after five months of three consecutive surgeries including initial surgery for uterine rupture during labor. On examination, a mass was noticed in the umbilical region. A foreign body was suspected on ultrasound and diagnosed as gossypiboma after surgery. It is usually misdiagnosed and needs attention especially considering differential diagnosis in post-operative patients. Such errors might be avoided by properly counting number of gauze pieces before and after an intervention, and usage of radio opaque gauze pieces.


Author(s):  
Dr. Najma Malik ◽  
Dr. Ruma Sarkar ◽  
Dr. Ankita Kumari ◽  
Dr. Vani Adtiya ◽  
Dr. Babita Vaswani Agarwal

2020 ◽  
Vol 11 (4) ◽  
pp. 22-26

Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality in developing countries. Objective: To determine the maternal outcome by an audit of one year among the cases of primary postpartum hemorrhage at a tertiary care hospital. Methodology: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, DHQ Teaching Rawalpindi from 1st January 2019 to 31st December 2019. A total of 9122 deliveries were conducted at the hospital. We reviewed the charts of all the patients who fulfilled our inclusion criteria and gathered data on a structured, pre-tested proformas prepared for the purpose. Results: A total of 9122 maternities were reported during the study period with the frequency of PPH 70 (0.77%). Booking status, 25 (35.7%), high parity 18 (25.7%), and uterine atony in 54 (77%) out of 70 PPH patients, were associated with PPH. Medical management of PPH with uterotonic drugs was successful in 23 (30%) of patients. Uterine packing was done in 27 (38%) patients and bleeding was successfully arrested in 24 (90%) of these 27 patients. Hysterectomy was performed in 9 (12.8%) patients. Maternal death due to PPH was reported in 1 (1.4%) cases. Conclusion: PPH is the leading cause of maternal mortality and morbidity, associated with booking status, parity, and uterine atony. Hospital management should emphasize the predefined protocol to be followed in managing a patient with postpartum hemorrhage.


2018 ◽  
Vol 121 (3) ◽  
pp. 306-311 ◽  
Author(s):  
Rana Chanchal ◽  
Sarika Gupta ◽  
Chandra Kanta ◽  
Kalpana Singh ◽  
Sciddhartha Koonwar

AbstractSevere acute malnutrition (SAM) is a major cause of child mortality and morbidity. Children treated for SAM are at risk of refeeding hypophosphataemia (HP). The study was done to find out the incidence and various predictors of moderate/severe HP in SAM among North Indian children. This prospective observational study was conducted from August 2014 to July 2015 in the inpatients’ department of Department of Paediatrics at King George’s Medical University, Lucknow, Uttar Pradesh, North India, a tertiary care teaching hospital. Before inclusion, ethical approval and written informed consent was obtained. Included in the study were sixty-five children aged 6–59 months of age, who were admitted to the hospital with SAM as per the WHO guidelines. SAM was defined as a mid-upper arm circumference <115 mm and/or weight-for-height/length <–3z-scores of the WHO growth standards and/or have bilateral oedema. Serum P levels were measured on admission and for five consecutive days after starting feed. HP was defined as mild, moderate and severe with a cut-off of 1·19–0·65, 0·65–0·32 and <0·32 mmol/l, respectively. About 60 % children had HP, with 20 % having moderate/severe HP at admission. The proportion of HP increased to 83·1 %, with 38·5 % having moderate/severe HP on day 3 after feeding. It was concluded that HP is a common biochemical abnormality in SAM. Considering its impact on the health of the child, serum P levels should be monitored in patients with SAM who are treated with enteral feeding.


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