Neonatal outcomes of birth asphyxia in tertiary care hospital of low-income country

Background: Pakistan has highest neonatal mortality in the region and birth asphyxia is one of the main preventable contributors to this. Objective of this study is to determine the frequency of different neonatal outcomes in neonates with birth asphyxia. Subjects & Methods: It was descriptive case series study conducted in Department of Pediatrics Medicine, Services Hospital, Lahore in 6 months period during 6th Dec 2016 to 5th June 2017. 150 cases were included using non probability, consecutive sampling with 95% confidence level, 6% margin of error taking an expected percentage of neonate mortality as 15%. Data was analyzed with SPSS version 23. Categorical variables i.e., gender and neonatal outcomes in terms of neonatal mortality, discharge and neurological complications were expressed by frequency and percentage. Post stratification chi square test was applied. A p-value of <0.05 was taken as significant. Results: The mean age of neonates was 3.09±0.8 hours. Outcomes of these neonates was seen in terms of mortality, discharge and neurological problems. Out of total 150 patients, 51 (34%) neonates expired and 99 (66%) neonates were survived. And neonates 69 (46%) neonates were diagnosed with neurological complications. Conclusion: We found, birth asphyxia has significant association with neonatal mortality and neurological complications. Prevention of birth asphyxia with appropriate resuscitation at birth may be helpful in reduction of morbidity and mortality due to birth asphyxia.Neonates

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COVID-19 and Pregnancy Outcome: An Experience in ‘COVID-19 Management Designated’ Tertiary Care Hospital, Rawalpindi, Pakistan

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24isupp-1.1453 ◽

2020 ◽

Vol 24 (Supp-1) ◽

pp. 85-91

Author(s):

Shazia Syed ◽

Humera Noreen ◽

Humaira Masood ◽

Ismat Batool ◽

Hina Gul ◽

...

Keyword(s):

Hepatic Encephalopathy ◽

Pregnant Women ◽

Clinical Characteristics ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Neonatal Outcomes ◽

Categorical Variables ◽

Care Hospital ◽

Case Series Study ◽

Maternal And Neonatal Outcomes

Background: The current COVID-19 pandemic has affected almost 17.3 million victims worldwide with mortality of almost 674K. Pregnancy is one of the most susceptible conditions for COVID-19 infection, but limited data is currently available about the clinical characteristics of pregnant women with the disease. Objective; to describe the clinical characteristics, co-morbidities, management, feto-maternal, and neonatal outcome in COVID-19 positive pregnant women. Methodology: A descriptive case series study was conducted in Obs/Gynae dept of Benazir Bhutto Tertiary Care Hospital, Rawalpindi, including all asymptomatic/symptomatic COVID-19 positive pregnant women and clinical suspects (COVID-19 PCR negative women) delivered in our hospital from 01st April 2020 to 31st July 2020. Their medical records were reviewed for clinical characteristics, management, feto-maternal and neonatal outcomes. Continuous variables were expressed in Mean & Range and Categorical variables as number & Percentage. Results: During the study period a total of 17 cases were reviewed. The mean maternal age was 28.94 yrs. Primigravida (07), Multipara (10). Mean gestational age was 37 wks (range; 30-41wks). Presenting symptomatology was varied. Asymptomatic; (29%), COVID-19 specific symptoms; fever & flu (12%), fever&cough (6%), shortness of breath(SOB) alone (6%), fever & SOB(6%) and pregnancy-related manifestations were labour pains (17%), eclampsia(6%), hydrocephalous fetus (6%) and hepatic encephalopathy(6%). The commonest co-morbidity was Hypertensive disorders of pregnancy (24%). Five women (29%) required ICU care. Lower segment caesarean sections(LSCS) (59%), vaginal delivery (41%). Eleven babies delivered with good Apgar score and birth weight. Two were early neonatal deaths (ENND) and 04 were received intra-uterine fetal deaths (IUDs). Fetal demise was associated with strong obstetric risk factors. Out of 13 live-born babies, RT-PCR Covid-19 testing was done in 10 (77%) cases and was negative. One mother was expired due to complications of hepatic encephalopathy, sepsis, and burst abdomen. Conclusion; The clinical course of COVID-19 disease in pregnancy seems to be no different from non-pregnant women. Clinical manifestations are diverse and infection contracted in the third trimester of pregnancy is associated with good feto-maternal and neonatal outcomes.

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Profile of neonatal mortality in special newborn care unit of tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20194205 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2319

Author(s):

Ashutosh Kumar Sharma ◽

Ajay Gaur

Keyword(s):

Respiratory Distress ◽

Neonatal Mortality ◽

Tertiary Care ◽

Birth Asphyxia ◽

Newborn Care ◽

Neonatal Morbidity ◽

Study Data ◽

Categorical Variables ◽

Care Hospital ◽

Danger Signs

Background: In India presently around 8 million LBW infant are born each year. India accounts for 24% of global neonatal mortality. Improving NMR is an essential component of reducing U-5MR. The aim of this study was to determine the causes of morbidity and mortality in neonates admitted in our hospital.Methods: This study was conducted at SNCU of Kamala Raja Hospital, Gwalior providing level III neonatal care. This is a retrospective hospital based observational study. Data from SNCU online database were taken for a period of 3 year from March 2016 to March 2019. Data obtained included sex, birth weight, Gestation age, morbidity profile, Diagnosis, and Mortality profile, Duration of stay and outcome. Categorical variables were tabulated and Statistical analysis was done.Results: A total of 12,027 neonates were recruited, 63.07% were males and 36.92% were females. 54.87% were extramural, while 45.13% were intramural neonates. Prematurity was the most common morbidity 56.98% in the admitted neonates. Major contributors to the neonatal morbidity were Birth asphyxia (24.61%), others (21.60%), Respiratory Distress(14.06%), Sepsis(13.77%). The mortality rate in the present study is 25.45%. Major contributors for neonatal mortality includes Respiratory distress (37.76%), Birth Asphyxia (26.75%), Sepsis(13.91%). Mortality was more in out born babies 33.03% compared to inborn babies 22.03%. Conclusions: Improving antenatal care, more deliveries at institutions with SNCU facility, improved access to health facility, early identification of danger signs, timely referral of high risk cases, capacity building, can reduce neonatal mortality and its complications.

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Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.9-1.157 ◽

2022 ◽

Vol 9 (1) ◽

pp. 75-81

Author(s):

Muhammad Bilal ◽

Shafqat Ali Shah ◽

Marina Murad ◽

Saad Ali ◽

Ammad Ali ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Tertiary Care ◽

Case Series ◽

Female Gender ◽

Posterior Capsule Opacification ◽

Posterior Capsule ◽

Diabetic Patients ◽

Care Hospital ◽

Case Series Study

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.

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Steroid-induced Rosacea- A Study From a Tertiary Care Hospital of Eastern Nepal

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v19i1.35952 ◽

2021 ◽

Vol 19 (1) ◽

pp. 25-29

Author(s):

Manoj Chaudhary ◽

Sudha Agrawal

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Case Series ◽

Sun Exposure ◽

Care Hospital ◽

Facial Erythema ◽

Case Series Study ◽

The Face ◽

Triggering Factor ◽

Study Population

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour. Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face. Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017. Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%). Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.

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A profile on the spectrum of neonatal mortality and morbidity pattern of extramural neonates in the Specialised Neonatal Care Unit (SNCU) in a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180529 ◽

2018 ◽

Vol 5 (2) ◽

pp. 427 ◽

Cited By ~ 1

Author(s):

Anuradha D. ◽

Rajesh Kumar S. ◽

Aravind M. A. ◽

Jayakumar M. ◽

J. Ganesh J.

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress ◽

Neonatal Mortality ◽

Low Birthweight ◽

Tertiary Care ◽

Birth Asphyxia ◽

Newborn Care ◽

Care Hospital ◽

Neonatal Deaths

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.

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Tracheo-bronchial foreign bodies: our experience at a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20161848 ◽

2016 ◽

Author(s):

Shashidhar S. Suligavi ◽

Mallikarjun N. Patil ◽

S. S. Doddamani ◽

Chandrashekarayya S. Hiremath ◽

Afshan Fathima

Keyword(s):

Foreign Body ◽

Early Diagnosis ◽

Foreign Bodies ◽

Tertiary Care ◽

Case Series ◽

Team Work ◽

Care Hospital ◽

Retrospective Case ◽

Presenting Symptoms ◽

Case Series Study

Background:Tracheo- bronchial foreign bodies have always posed a challenge to the ENT surgeon as they present with varied symptomatology ranging from a simple cough and fever to more grave respiratory distress. It requires a strong suspicion, early diagnosis and timely intervention to reduce the overall morbidity and mortality .This study was undertaken to highlight our experiences in handling cases of tracheo- bronchial foreign bodies (FB) at our setup.Methods:It is a retrospective case series study conducted in S. Nijalingappa Medical College between January 2011 and January 2015. Results:Most commonly affected were children between 1year to 3years of age. Chronic cough and wheeze were the commonest presenting symptoms. Vegetative foreign body was found to be the commonest variety of foreign body. The mortality rate in our study was 4.7% (n=3).Conclusions:A good clinical acumen, team work, early diagnosis and timely intervention are all needed to reduce the overall mortality and morbidity associated with tracheo- bronchial foreign bodies.

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Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

Bangladesh Journal of Endosurgery ◽

10.3329/bje.v2i1.19588 ◽

2014 ◽

Vol 2 (1) ◽

pp. 9-14

Author(s):

Sheikh Shawkat Kamal

Keyword(s):

Middle Ear ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Retrospective Case ◽

Middle Ear Mucosa ◽

Case Series Study ◽

Temporal Bones ◽

Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27 ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

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Laparoscopic Surgical Management of Rectal Cancer at Tertiary Care Hospital

10.53350/pjmhs2115113285 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3285-3287

Author(s):

Zubair Yousfani ◽

Jabeen Atta ◽

Khenpal Das ◽

Madhu Bala ◽

Shagufta Magsi ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Hospital Stay ◽

Tertiary Care ◽

Case Series ◽

Operation Time ◽

Health Sciences ◽

Care Hospital ◽

Average Hospital ◽

Case Series Study

Objective: To evaluate the consequent outcomes in the patients with rectal cancer endured laparoscopic surgical excision at Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro, Hyderabad and to review their curative resection and recurrence rates, postoperative morbidities and complete survival. Methods: This prospective case series study was done at the Department of General Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan. All patients of 30-65 years ages with rectal cancer and underwent diagnostic laparoscopy either of gender were included. After removing the tumor, the specimen pinned out on a flat surface and placed in fixative solution to allow the orientation of the specimen and assessments of the exact margins. As the specimens had acceptable clear margins and limited invasion to the submucosa, no further surgical procedure was proceeded. Data was collected via study proforma. Results: A total of 40 patients were studied. Patients in the laparoscopic operation lost less blood with an amount of only 200mL during 190 minutes average operation time. The bowel functioning returned in 2 days averagely with 8 days average hospital stay. Conclusion: It is concluded that laparoscopic surgery for rectal cancer is an effective, safe and feasible approach in terms of less post-operative complications and recovery time as well as Hospital stay. Key words: Rectal Cancer, laparoscopic surgery

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Analysis of caesarean section rate in tertiary care hospital according to Robson`s 10 groups classification

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181023 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1380

Author(s):

Varija T. ◽

Veerendra Kumar C. M. ◽

Chandrasekhar Tarihalli

Keyword(s):

Caesarean Section ◽

Classification System ◽

Caesarean Section Rate ◽

Tertiary Care ◽

Case Series ◽

Breech Presentation ◽

Group Classification ◽

Care Hospital ◽

Case Series Study ◽

Group 5

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

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Frequency and Outcome of Hypoglycemia in Severely Malnourished Children at Tertiary Care Hospital Larkana

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i4431080 ◽

2021 ◽

pp. 51-56

Author(s):

. Rizwana ◽

. Bhagchand ◽

Gulab Rai ◽

Chetan Das ◽

Shanti Lal ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Series ◽

Serum Glucose ◽

Care Hospital ◽

Anthropometric Measures ◽

Malnourished Children ◽

Case Series Study ◽

Gender And Age ◽

Mid Upper Arm Circumference

Objective: To determine frequency and outcome of hypoglycemia in severely malnourished children at tertiary care Hospital Larkana. Methodology: This descriptive, case series study was carried out at the department of Pediatric Medicine Chandka Medical Hospital Larkana, during 6 months. Severely malnourished children of both gender and age between 6 months to 5 years were enrolled. Severity of malnutrition was evaluated as per standard anthropometric measures i.e. height, body weight, MUAC (mid upper arm circumference) by standard MUAC tape. Hypoglycemia was assessed by checking random blood sugar on glucometer. All the data was recorded via self-made proforma and analyzed by using SPSS version 20. Results: Mean age of the patients was 24.27±15.30 months. Mean MUAC was 9.39±1.56. There were 96 (52.20%) females and 88 (47.80%) males. Mean serum glucose level was found to be 86.02±21.58 mg/dL. There were 23(12.50%) patients with hypoglycemia and out of which 16 (69.60%) patients expired and 7 (30.40%) patients survived. Conclusion: Hypoglycemia was found to be 12.50% in severely malnourished children and it was significantly associated with adverse outcome.

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