EVALUATION OF THE ETIOLOGIES AND OUTCOME OF PRETERM LABOUR

Objective : This is a Prospective cohort study carried out in department of Obstetrics and Gynaecology, Hi-Tech Medical College & Hospital, Bhubaneswar, a tertiary care centre, with the objective of knowing the etiology and outcome of preterm labour and formulate measures to prevent the onset of preterm labour and deal with complications arising from preterm labour. Materials and methods : A total of 112 patients with preterm labour were included in the study. The investigations required to identify the etiology and also other routine investigations were carried out . The study was conducted over a two year period i.e. from November 2018 to October 2020 at Hi-Tech Medical College & Hospital, Bhubaneswar. Results : Majority of the patients were in the age group of 20-24 years. Among them, majority of the patients belonged to the gestational age group of 28-34 weeks . Infection was the commonest cause of preterm labour. There is signicant improvement in neonatal outcome in steroid covered group if gestational age is less than 34 weeks . Conclusion: Preterm labour has major impact on neonatal mortality and morbidity. Hence identication of risk factors and etiologies of preterm labour and timely interventions in the form of investigations and management and preparedness to tackle the maternal and neonatal complications are vital for a good maternal and neonatal outcome.

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A prospective observational study of breech pregnancy in a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200359 ◽

2020 ◽

Vol 9 (2) ◽

pp. 688

Author(s):

Somika Kaul ◽

Bijal D. Rami

Keyword(s):

Prospective Observational Study ◽

Tertiary Care ◽

Mode Of Delivery ◽

Breech Presentation ◽

Age Group ◽

Tertiary Care Centre ◽

Mortality And Morbidity ◽

Obstetrics And Gynaecology ◽

Labour Room ◽

Case Basis

Background: Breech presentation is the commonest of all mal presentations. Vaginal delivery of breech presentation at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, S. S. G. Hospital, Baroda for a period of six months from 1st May 2019 to 31st October 2019. Out of a total number of 4476 deliveries, 159 were breech pregnancy. It included all the women admitted in labour room or ward who delivered with clinical or ultrasound diagnosis of breech presentation after 20 weeks of gestation.Results: In the present study incidence of breech pregnancy was 3.6%. Authors observed the highest incidence of breech pregnancy in the age group of 20 to 25 years. Maximum (62.9%) cases delivered after 37 weeks of gestation. In our study 62.3% cases were primigravida and 37.7% were multigravida. Majority of cases (77.4%) delivered by caesarean section. Among all the babies born 50.6% were having birth weight of less than 2.5 kg.Conclusions: Authors need to study and analyse all cases of breech pregnancy individually to decide the management and mode of delivery depending on cases to case basis and expertise of the staff available. Delivery of breech foetus should be conducted by experience obstetrician after appropriate consent from pregnant women and her relatives.

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Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172319 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2395

Author(s):

Divya Gupta ◽

Premlata Mital ◽

Bhanwar Singh Meena ◽

Devendra Benwal ◽

. Saumya ◽

...

Keyword(s):

Twin Pregnancy ◽

Tertiary Care ◽

Comparative Assessment ◽

P Value ◽

Care Centre ◽

Tertiary Care Centre ◽

Singleton Pregnancy ◽

Medical College ◽

Obstetrics And Gynaecology ◽

Twin Pregnancies

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

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Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20214371 ◽

2021 ◽

Vol 8 (11) ◽

pp. 3359

Author(s):

Lokesh M. G. ◽

S. Chandrashekar ◽

Arundathi Raikar ◽

Abhishek S. S.

Keyword(s):

Perioperative Complications ◽

Tertiary Care ◽

Surgical Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Hollow Viscus ◽

Mortality And Morbidity ◽

Medical College ◽

Threatening Condition ◽

Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

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Study of common clinical types of cutaneous tuberculosis: two years study experience in a tertiary care centre

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200596 ◽

2020 ◽

Vol 6 (2) ◽

pp. 199

Author(s):

Raghu M. T. ◽

Ashwini S. ◽

Yogendra M. ◽

Virupakshappa H. E. ◽

Gangaraju Harish ◽

...

Keyword(s):

Tertiary Care ◽

Age Group ◽

Lupus Vulgaris ◽

Tertiary Care Centre ◽

Cutaneous Tuberculosis ◽

Medical College ◽

Plaque Type ◽

Study Experience ◽

The Common ◽

Work Up

Background: Cutaneous tuberculosis (TB) is frequently found worldwide, especially in tropical countries. The number of extrapulmonary TB reaches up to 14%, and 1% to 2% are cutaneous TB. Diagnosis of cutaneous tuberculosis (CTB) is complicated and requires a full work-up. Clinical manifestation of cutaneous TB is varied and causes difficulties to diagnose. Scrofuloderma and plaque type of lupus vulgaris (LV) are common forms of cutaneous TB.Methods: A retrospective study was conducted on patients attending Department of Dermatology, Venereology and Leprosy, at Basaveshwara Medical College and Hospital, Chitradurga over a period of 2 years. A total of 15 cases of cutaneous tuberculosis were diagnosed.Results: A total of 15 cases out of which included predominantly males, with age group being affected commonly are 20-40 decades, histopathology showing tuberculoid granuloma in 11 cases, and common clinical variant being lupus vulgaris seen in 66.6% of the cases and. Second common being scrufuloderma seen in 26.6% of the cases and least common is TB verrucosa cutis (TBVC) seen in 6.6% of the cases.Conclusions: The study showed that the common clinical type of cutaneous tuberculosis during the study period was lupus vulgaris, scrofuloderma and less common being TBVC.

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A PROSPECTIVE HISTOPATHOLOGICAL STUDY OF MENINGIOMAS IN A TERTIARY CARE CENTRE OF VIJAYAWADA

10.36106/gjra/9100428 ◽

2021 ◽

pp. 11-13

Author(s):

C.Bhanu Sree ◽

P. Annapurna ◽

M. Rajani

Keyword(s):

Surgical Resection ◽

Tertiary Care ◽

Histopathological Study ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Medical College ◽

Histological Appearance ◽

Classi Cation ◽

A Prospective Study

Background: Meningiomas are neoplasms arising from the arachnoidal cap cells in the meningeal coverings of the spinal cord and brain. These are the most common benign intracranial tumours and account for about 13-26% of all primary brain neoplasms. These are generally benign neoplasms of adults most often seen in middle age, but about 10% are atypical or malignant. These neoplasms are graded by WHO as Grade I , II and III . Benign meningiomas can be cured by surgical resection where as higher grade meningiomas require radiotherapy after surgical resection as these higher grade meningiomas have greater recurrence and aggressive behavior. Aims and Objectives: To study the variants and histopathological spectrum of meningioma and prognosis of variants. Material & Methods: The present study is a prospective study conducted in the department of Pathology, Siddhartha medical college from June 2019-May 2020. During this study, 16 cases of meningiomas were diagnosed and reviewed. Result:In our study of 16 cases females were 62.5%. The most common age group is 41-60 yrs (68.75%). Most common variant was noted to be transitional meningioma followed by meningothelial meningioma. Out of the 16 cases, grade I were 81.25%. Conclusion: Meningiomas account for 28-30% of primary central nervous system tumors and unveil a heterogeneous histopathology. The histological appearance of meningioma determines the grading for the management of the various subtypes and also associated with patient's prognosis. Hence a continuous revision of histopathological classication systems is required to improve the diagnostic accuracy. Benign meningiomas are the most common type. From our study, we conclude that transitional meningioma is the most common benign variant.

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Profile of new Patients attending Psychiatry Out-patient Department at Lumbini Medical College-Teaching Hospital, Palpa

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v6i2.21759 ◽

2018 ◽

Vol 6 (2) ◽

pp. 42-44

Author(s):

B Sharma ◽

A Devkota ◽

SC Pant

Keyword(s):

Psychiatric Illness ◽

Tertiary Care ◽

College Teaching ◽

Age Group ◽

Household Work ◽

Care Centre ◽

Tertiary Care Centre ◽

Level Of Education ◽

Primary Level ◽

Medical College

Introduction: Study on prevalence of psychiatric disorders in Palpa and nearby districts which lie in western Nepal, is not much studied till date. We therefore conducted this study aiming to see the pattern of psychiatric illness in an Outpatient Department of Lumbini Medical College which is a tertiary care centre located in Palpa district.Material And Method: : This is a retrospective study where outpatient record of all new cases attending the Psychiatry OPD from 29th Oct 2014 to 29th Dec 2014 were studied and statistical analysis were done. The number of new patients were 107.Results: Out of 107 patients, 60.74 % (65)) were females and 39.26 %( 42) were males. Patients of age group 31-40yrs showed the largest proportion (27.49%) followed by age group 41-50yrs (24.29%). Majority cases were illiterate (69.15%) followed by primary level of education (14.95%). The occupation of most of the cases were household work (35.51%) followed by farming (31.77%). Anxiety disorder (27.10%) was the most frequent diagnosis ahead of “Others” (18.69%) followed by depressive disorder (15.88%).Conclusion: Most of the new patients attending the psychiatry OPD of Lumbini Medical College were females, of 31-40 age group and most of the patients suffered from anxiety disorders. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 42-44

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Maternal and perinatal morbidity and mortality in COVID-19 positive obstetrics patients in tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212650 ◽

2021 ◽

Vol 10 (7) ◽

pp. 2676

Author(s):

Medha . ◽

Neeta Chaudhary ◽

Smita Tyagi ◽

Kirtigiri G. Goswami

Keyword(s):

Intensive Care ◽

Neonatal Outcome ◽

Tertiary Care ◽

Common Symptom ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Health Crisis ◽

Medical College ◽

Satisfactory Condition ◽

Fluctuating Course

Background: COVID-19 disease had been declared as a public health crisis by WHO by the end of 2019. The effect of SARS-CoV-2 infection on pregnancy including symptoms, disease severity, risk of vertical transmission and perinatal and neonatal outcome have been the subject of research. Preliminary studies showed a fluctuating course of the disease ranging from asymptomatic or mild symptoms to even maternal death. However, recent evidences suggest that effect of COVID-19 infection during pregnancy may not lead to adverse maternal and neonatal outcome.Methods: In this cross sectional prospective observational study, we analysed 60 pregnant women infected with SARS- CoV-2 and their neonatal outcome, who tested positive for COVID-19 at district hospital, and were referred to Muzaffarnagar Medical College, were enrolled in this study.Results: The majority 96.7% (58) of these women were asymptomatic with cough being the most common symptom which was present in 3.3% (2) of the women. 24(75%) women developed pneumonitis radiologically, but they were asymptomatic, so intensive care was not required. Along with 76.08% (35) perinatal/neonatal outcomes were observed normal.Conclusions: In this study we observed that most of the women with COVID-19 were asymptomatic or with mild symptoms. Even though they were asymptomatic, most of the patients showed pneumonitis changes radiologically but still they didn’t require any intensive care, had good recovery postpartum and were discharged under satisfactory condition. The neonatal outcome was highly favourable.

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Clinical Characteristics and Endoscopic Findings of the Patients with Cirrhosis of the Liver in a Tertiary Care Centre in Eastern Nepal

Journal of Nobel Medical College ◽

10.3126/jonmc.v5i1.15750 ◽

2016 ◽

Vol 5 (1) ◽

pp. 26-31

Author(s):

Ram Hari Ghimire

Keyword(s):

Clinical Characteristics ◽

Tertiary Care ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Gastroesophageal Varices ◽

Medical College ◽

Endoscopic Findings ◽

Cirrhotic Patients ◽

Upper Gastrointestinal

Background Studies on clinical characteristics and upper gastrointestinal endoscopic findings of the cirrhotic patients in a tertiary care centre are sparse from eastern region of Nepal. The aim was to profile these patients clinically and analyse the endoscopic findings.Material and Methods This was a cross-sectional analytical study carried out in the Department of Medicine of Nobel Medical College, Biratnagar from 30st September 2012 to 30th August 2013(one year). After admission, detail medical history and meticulous clinical examination was carried out in every patient with clinical diagnosis of cirrhosis of liver. Routine, biochemical, hematological, imaging and special investigations were sent as per clinical scenario. Upper gastrointestinal endoscopy was carried out in all patients. Basic descriptive statistics were used to present the data.Results A total of 104 patients were enrolled in our study. The mean age was 50.09 years ± 11.79 (Range 26-79), of which 60% were males. Almost 70% of the patients were from productive age group (31-70 years). All the patients were symptomatic. Chronic excessive alcohol consumption was the commonest cause of cirrhosis (80.76%). The major clinical presentations were ascites (83.65%) and jaundice (79.92%). Pedal edema was the commonest (85.6%) presenting sign. Diabetes mellitus and pneumonia were common comorbidities. Gastroesophageal varices were commonest (70.19%) endoscopic finding.Conclusion Cirrhotic patients presented late with complete decompensation in the form of ascites, jaundice and upper gastrointestinal bleeding from esophageal varices. Mostly people with productive age group were affected.Journal of Nobel Medical College Volume 5, Number 1, Issue 8, January-July 2016, 26-31

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Demographic profile of subjects undergoing tympanoplasty in a tertiary care centre of Punjab: analysis of 60 cases

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20202985 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2613

Author(s):

Manish Munjal ◽

Gopika Talwar ◽

Shubham Munjal ◽

Tulika Saggar

Keyword(s):

Gender Discrimination ◽

Elective Surgery ◽

Tertiary Care ◽

Age Group ◽

Tertiary Care Centre ◽

Suppurative Otitis Media ◽

Medical College ◽

Minimum Age ◽

Study Population ◽

Male Patients

Background: Different tympano meatal vascularised flaps were compared in the tympanoplastic surgery in chronic suppurative otitis media.Methods: 60 cases with diagnosis of chronic suppurative otitis media were selected from ENT OPD of Dayanand Medical College and Hospital Ludhiana. 6 types of tympanomeatal flaps were used and 10 cases of each flap were taken. The study was conducted for the period of 1 year from June 2015 to August 2016.Results: Maximum numbers of patients were in the age group of 31-40 years (26.7%), followed by age group of >50 years (23.3%). Minimum age among these patients was 11 years and maximum 65 years. Mean age was 36.67. Graft failure was in 2 patients, 1 lies under age group 31-40 years and other was in more than 50yrs group. Female patients constituted 56.7% and male patients were 43.3% in our study population. Graft uptake was 93% in females and 100% in males. In our study on 60 patients, 41 (68.3%) patients had a rural and 19 (31.7%) an urban background.Conclusions: Age does not affect the results of tympanoplasty, whatever flap maybe utilised. Awareness in rural population regarding reconstructive ear surgery is there nowadays though there is still gender discrimination, with less number of ladies opting for this elective surgery.

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ASSESSMENT OF NEONATAL OUTCOME IN BOOKED AND UNBOOKED PREGNANCY CASES IN A TERTIARY CARE CENTRE

10.36106/gjra/6710152 ◽

2021 ◽

pp. 63-65

Author(s):

Pranoy Dey ◽

L. Lotha ◽

Sawant Kumar Sahu ◽

Rajlakshmi Borgohain

Keyword(s):

Birth Weight ◽

Child Health ◽

Gestational Age ◽

Neonatal Outcome ◽

Tertiary Care ◽

Neonatal Outcomes ◽

Care Centre ◽

Tertiary Care Centre ◽

Neonatal Deaths ◽

And Child Health

Majority of neonatal deaths occurs in low and middle income countries indicating poor quality of health services provided by the government of the respective countries.In a developing country like India , a high morbidity and mortality serves as an sensitive indicator reecting the poor maternal and child health care services of the country.Most of the neonatal deaths can be attributed to avoidable factors which can be minimized by the effective utilization of antenatal services , early detection of high risk pregnancy and timely referral of these cases.The current study was conducted to determine the neonatal outcomes in booked and unbooked pregnancy cases in the tertiary care centre ,Assam Medical College and Hospital, Dibrugarh. METHODS: Close ended structured questionnaires were used to collect information from the parents (150 booked and 150 unbooked).Neonatal outcomes were categorised under groups of term and preterm ,live birth and stillbirts, birthweight, Gestational age, iugr, large for gestational age APGAR score ,NICU admissions and clinical course during hospital stay,course during rst 28 days of life along with complications,if any are all taken into consideration. RESULTS: During the study period 28.67% had low birth weight in booked cases and 41.33% had low birth weight in unbooked cases.The incidence of stillbirth and early neonatal deaths were 2%,4% respectively in booked cases and 4.67% , 6% respectively in unbooked cases.Higher incidence of MSL,prematurity ,birth asphyxia ,respiratory problems ,birth injuries,congenital malformations,infections and hyperbilirubinemia were seen in unbooked cases. CONCLUSIONS: The inference derived from the study ,showed that availability of antenatal care is directly proportional to the neonatal outcome .Thus unavailbility or lack of proper medical attention during the pregnancy results in unfavourable neonatal outcomes which can be prevented by increasing the range of availability , utilization and effectiveness of maternal and child health services alongwith ensuring booking of all the pregnancy cases in our country.

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