scholarly journals Craniocerebral missile injuries in civilian Kashmir – India

1970 ◽  
Vol 29 (2) ◽  
pp. 13-28 ◽  
Author(s):  
BA Rashid ◽  
MA Wani ◽  
AR Kirmani ◽  
TH Raina ◽  
S Raina
Keyword(s):  
Tertiary Care ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Conflict Zones ◽  
Set Up ◽  
The Third World ◽  
Tertiary Care Hospitals ◽  
Modern Era ◽  
The Brain ◽  
Overall Mortality

Background The missile injuries of the cranium and brain in the modern era have shifted from soldiers to the civilians and from the battle grounds to the populated zones due to increase in the terrorist and military strikes. The management of the victims depends on the resuscitation at the site of injury and the distance and transportation to the tertiary care centre. This article presents the details of the missile injuries to the brain, the third-world problems and the management. Material and methods A retrospective analysis of 3794 craniocerebral missile injuries, managed by the Department of Neurosurgery at Sher-I-Kashmir Institute of Medical Sciences (SKIMS) Kashmir, India, over a period of more than 21 years from September 1988 to September 2009. Patients were triaged in emergency CT-room, resuscitated and operated. Statistical software programme SPSS 11.5 was used to derive the numerical significance. Results Revealed an overall mortality of 87.69% (3327 out of 3794). Most of the deaths 79.14% (2633 out of 3327) occurred within 30 minutes of the patient’s arrival to the hospital and only 694 patients lived beyond one hour of arrival. Conclusion Presently the quantum of outcome i.e, survival and good recovery in craniocerebral missile injuries appears a meager heap compared to the huge amount of death and disability. And the situation will continue to be so unless tertiary care hospitals are set up within and around the armed and conflict zones, war torn areas and battle fields, rather than risking transportation, time of resuscitation, intervention and the results.Key words: Craniocerebral, Kashmir, Missile Injuries, Outcome.

scholarly journals Tubercular mastitis: An institutional experience from a tertiary care centre of northern India

2017 ◽  
Vol 8 (3) ◽  
pp. 72-75
Author(s):  
Amit Gupta ◽  
Lovenish Bains ◽  
Deepshikha Yadav ◽  
Prashant Durgapal ◽  
Manish Kumar Agrawal
Keyword(s):  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Aspiration Cytology ◽  
Northern India ◽  
Institutional Experience ◽  
Needle Aspiration Cytology ◽  
High Index Of Suspicion

Background: Tuberculous mastitis (TM) is a rare extra pulmonary presentation of tuberculosis. It may be problematic to distinguish from carcinoma breast, a condition with which it may coexist.  Fine needle aspiration cytology (FNAC) / biopsy are indispensable for diagnosis and tuberculosis culture when positive may be very valuable to guide antimicrobial therapy.Aims and Objectives:  To disseminate the message to the concerned expertise that it can present a diagnostic problem on radiological and microbiological investigations, and thus a high index of suspicion is needed.Materials and Methods: 19 cases of tubercular mastitis between  January 2012 to March 2014 were identified and included in the present study. Cytology and biopsy alongwith AFB stain was done for confirmation.Results: Age ranged between 23- 55 years (median 33 years). Axillary nodes were palpable in 9 (47.3%) patients. Acid Fast Bacilli stain which was positive in only 3 patients. All the 19 patients were started on antitubercular treatment.Conclusion: This study highlights the importance of early diagnosis and aggressive medical and if required surgical management to cure this disease.Asian Journal of Medical Sciences Vol.8(3) 2017 72-75

scholarly journals Awareness Regarding Implant Supported Dental Prosthesis; A Survey In Tertiary Care Set Up

2018 ◽  
Vol 08 (04) ◽  
pp. 250-253
Author(s):  
Anum Baqar ◽  
Saman Hakeem ◽  
Farnaz Ilyas ◽  
Abid Mohsin ◽  
Fatima Hassan ◽  
...  
Keyword(s):  
Dental Implant ◽  
Tertiary Care ◽  
Limiting Factor ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Dental Hospital ◽  
Set Up ◽  
Systemic Health ◽  
Implant Treatment

Objective: This research was aimed to assess the awareness and attitude regarding implant-retained prosthesis as the most advanced option for tooth replacement amongst residents of Karachi visiting tertiary care centre. Methodology: This cross-sectional survey was conducted in the department of Prosthodontics at Bahria University Dental Hospital, Karachi. Undertaking the demographic characteristics of patients, the objective was to determine the awareness and attitude toward implant supported prosthesis. Results: Amongst 380 responses retrieved, 9.8% of respondents were aware about the dental implant treatment. While correlating awareness with demographics features, awareness statistically increased with educational level (p= 0.00) and occupational category(p=0.01) of the participants. The friends and relative s(40.5%) were the main source of information regarding dental implant treatment modality. 54.1% were unwilling to undergo treatment with dental implant whereas high cost (55.2%)was the major limiting factor for implant treatment. 64.9% demanded dental insurance for getting the treatment. 45.9% had no knowledge regarding maintenance of implant supported prosthesis .73.0% had no idea regarding longevity of dental implant where as 86.5% were unaware of it’s impact on systemic health. Conclusion: The overall awareness regarding implant supported prosthesis was found to be minimal. This underlines the need of efforts and measures that should be made to raise the awareness and thus alter attitude towards dental implant therapy. Expensive rates (55.2%) was found to be the major limiting factor that should be relieved in the form of health insurance policies, especially in the developing countries like ours.

scholarly journals Study of caesarean section at tertiary care centre: a retrospective study

2020 ◽  
Vol 9 (5) ◽  
pp. 2138
Author(s):  
Varsha Kose ◽  
Kumari Sadhvi
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
High Rate ◽  
Audit And Feedback ◽  
Research Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Failure Of Induction

Background: Caesarean section (C-section) is one of the most widely performed surgical procedure in obstetrics worldwide. The WHO guidelines revised in 1994 states that the proportion of C-section birth should range between 5-15% but both in developed and developing countries C-section rate is on the rise. This study was conducted to analyse the frequency and indications for C-section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period from January 2018 to May 2019 at the department of obstetrics and gynecology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Hingna, Nagpur, Maharashtra, India. Data of patients who delivered by C-section in our hospital during the defined study period were studied and statistically analysed according to various parameters namely, the frequency of caesarean section, its indications, age, parity and gestational age of the patient.Results: The total number of women delivered over the study period were 2811. Out of which C-sections were done in 1461 women (51.97%). Previous C-section was the leading indication in 35.72% women followed by fetal distress 14.09%, failure of induction 12.93%, arrest of labour 7.93%, PIH 7.18%, oligo/IUGR 6.50%, breech 4.44%, refusal of vaginal birth 4.24%, CPD 1.71%, bad obstetrics history (BOH) 1.43%, malpresentation 1.30%, prematurity 1.23%,  and multifetal gestation in 1.09% women. Two women had classical C-section 0.07. 14.09% women had various complications. There was no maternal mortality.Conclusions: A high rate of caesarean deliveries was observed. Individualization of the indication and careful evaluation, following standardized guidelines can help us to limit C-section. Audit and feedback are the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup.

Treatment Outcomes of the Standardized Shorter MDR-TB Regimen under Programmatic Setting: A Retrospective Study from a Tertiary Care Centre, India

2021 ◽  
Vol 17 ◽  
Author(s):  
Swathi Karanth M.P ◽  
Somashekar M ◽  
Anushree Chakraborty ◽  
Swapna R ◽  
Akshata J.S ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mdr Tb ◽  
Set Up

Background: The shorter regimen was widely accepted and advocated for MDR-TB treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens in a programmatic setting will help in tailoring the treatment regimen of MDR-TB. Objectives: 1. To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen. 2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions in the shorter MDR-TB regimen. Methods: A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens were recorded. Treatment success is defined as ‘disease cured and treatment completed’, whereas treatment failure was considered when the treatment was either terminated or changed due to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion in the continuation phase. Results: The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher with a shorter MDR-TB regimen (p=0.0001). Conclusion: Treatment success with the shorter MDR-TB regimen though higher than the conventional regimen, is still way behind the target treatment success rate. Improving treatment adherence remains pivotal for achieving end TB targets.

Disseminated TB in inpatient deaths at a tertiary care centre: an autopsy study over three decades

2021 ◽  
Vol 25 (4) ◽  
pp. 271-276
Author(s):  
U. N. Siakia ◽  
V. Vishwajeet ◽  
R. Kumar ◽  
V. Suri ◽  
K. Joshi ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Reproductive Organs ◽  
Hospital Inpatient ◽  
Tertiary Care Centre ◽  
Autopsy Study ◽  
Atypical Symptoms ◽  
Significant Burden ◽  
Post Graduate Institute ◽  
The Brain ◽  
Significant Mortality

BACKGROUND: One of the most severe forms of TB, disseminated TB (dTB) is associated with significant mortality. A retrospective study was undertaken to assess the proportion of dTB among inpatient deaths and to describe the pathological spectrum of lesions. Associated comorbidities and missed dTB cases ante-mortem were also sought.METHODS: Data on autopsy-confirmed cases of dTB from over three decades (1988–2016) obtained from the departmental archives of the Post Graduate Institute of Medical Education and Research, Chandigarh, India, were reviewed for clinical details, as well as gross and histopathological findings. The proportion of autopsy-confirmed dTB were reported.RESULTS: During this period, a total of 243 autopsy-confirmed cases were retrieved. The organs most commonly involved in these cases were the lungs (90.1%), followed by the liver (72%), spleen (44%), kidneys (37%), bone marrow (17%), adrenals (12.2%), intestine (11.4%), pancreas (8.5%) and reproductive organs (6.9%). The brain was involved in 73.3% cases. In one third of cases, the diagnosis of TB was not suspected ante-mortem. Comorbid conditions were noted in 36.2% cases.CONCLUSION: A significant burden of dTB was noted among hospital inpatient deaths. Due to multi-organ involvement, dTB has atypical symptoms and may remain undiagnosed ante-mortem. Increased awareness and robust screening of TB cases are mandatory, particularly in patients with underlying comorbidities.

scholarly journals Analysis of repeat LSCS in a tertiary care centre

2018 ◽  
Vol 7 (5) ◽  
pp. 1963
Author(s):  
M. Poovathi ◽  
Suilharsini T. S.
Keyword(s):  
Caesarean Section ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Management Strategies ◽  
Negative Consequences ◽  
Care Needs ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Set Up

Background: Caesarean section (CS) rates continue to increase worldwide, particularly in middle and high-income countries without evidence indicating substantial maternal and perinatal benefits from the increase and some studies showing negative consequences for maternal and neonatal health. The objective of this study is to analyse the repeat caesarean section rates in a tertiary centre.Methods: This is a retrospective study carried out in the Department of Obstetrics and Gynaecology, Pudhukottai Medical College, Tamil Nadu, India for a 12-month period from January 2017 to December 2017 with the aim to analyse the rate and indications for caesarean section and to identify the measures to decrease its incidence if possible. A total of 2654 cesarean deliveries were conducted in one year, out of which 1380 (51.99%) were primary cesarean sections and 1274(48%) were repeat cesarean sections.Results: Repeat LSCS is more common in age group of 21-30 years (80%) and in second gravida (90.42%). The incidence of caesarean section is 94.6%. Patients who had successful trial of scar were 73. In all these patients, measures were taken to shorten the 2nd stage of labour either by giving episiotomy alone or by application of outlet forceps or vacuum. Out of these 62 (84.9%) patients were delivered by episiotomy alone.Conclusions: Caesarean section has become one of the commonly performed surgeries in obstetric practice. Implementation of standard labour management strategies can reduce primary caesarean section rate without compromising maternal and fetal safety. One important strategy is ROBSON ‘S 10 GROUP classification system for caesarean section needs to be adopted. Targets of care needs to be set up which also depends on the available resources and expertise. With continuous critical review as described and frequent comparison with other delivery units, the caesarean section rate in each individual unit can be reduced to an appropriate level.

scholarly journals Peripartum Hysterectomy in a Teaching Hospital in India

2013 ◽  
Vol 4 (1) ◽  
pp. 5-9
Author(s):  
Swati Agrawal ◽  
Reena Yadav ◽  
Chitra Raghunandan ◽  
Shilpa Dhingra ◽  
Harvinder Kaur
Keyword(s):  
Tertiary Care ◽  
Hemodynamic Instability ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Mortality And Morbidity ◽  
Maternal Characteristics ◽  
Peripartum Hysterectomy ◽  
Characteristics Method ◽  
Life Saving

Objectives: To find the incidence and clinical implications of peripartum hysterectomy in a tertiary care centre of India. Methods: A retrospective study of all cases of caesarean and postpartum hysterectomy between January 2006 and December 2011. Maternal characteristics, method of delivery, indications for hysterectomy and complications were reviewed. Results: The rate of peripartum hysterectomy was 0.47:1000 deliveries. Most were operative deliveries. The main indications were placenta accreta (38.88%), massive atonic PPH (36.11%) and uterine rupture (22.22%). Half the hysterectomies were subtotal while the rest were total. Maternal morbidity was high and there were seven maternal deaths (19.44%). All deaths were in patients brought in a critical condition to the hospital after massive blood loss. Conclusion: Peripartum hysterectomy is potentially a life saving procedure but the mortality and morbidity is high, especially if performed late when the hemodynamic instability has already set in. DOI: http://dx.doi.org/10.3126/ajms.v4i1.6967 Asian Journal of Medical Sciences 4(2013) 5-9

scholarly journals Awareness of human papilloma virus (HPV) vaccine female doctors working in tertiary care centres.

2021 ◽  
Vol 28 (04) ◽  
pp. 464-469
Author(s):  
Zahra Safdar ◽  
Faisal Ashraf ◽  
Alia Bashir
Keyword(s):  
Hpv Vaccine ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Common Causes ◽  
Tertiary Care Hospitals

Objectives: The aim of the study is to assess the awareness about various aspects of HPV infection and vaccine among female doctors working in tertiary care centres. Study Design: Cross Sectional study. Setting: 3 Tertiary Care Hospitals Lahore. Period: Jan 2018 Jan 2019. Material & Methods: 478 female doctors from 03 tertiary care hospitals (Lady Atchison hospital, Lahore General Hospital and Services Institute of Medical Sciences) in Lahore who voluntarily filled 18-point self-administered questionnaire assessing their knowledge about HPV infection (8) HPV vaccine (5) and opinions about it (5). Knowledge score (range 0-8), assuming adequate knowledge > median. Factors associated with opinions were explored and analysed. Results: Most replied knowledge questions correctly 67.2%, 39.5% perceived it as frequently occurring infection. Median knowledge was 6 out of 8 questions; lack of knowledge was associated with non ob-gynae speciality or junior level. None of the participants were immunized but 46.3% were willing to get vaccinated themselves 78.1% were willing to get their daughters vaccinated. Self-perceived under exposure of HPV infection was 67.9%. Lack of feeling it as important in our social setting (28.6%), and expensiveness (19.4%) were most common causes of not counselling the patient about HPV vaccine and counselling to get vaccinated was most commonly done as it saves patients from cervical cancer (86.8%). Conclusions: Despite adequate knowledge of HPV infection and effectiveness of its vaccination, female doctors working in tertiary care hospitals of Lahore’s are not efficiently spreading awareness to the society and prescription of the vaccination is also deficient.

scholarly journals Study of febrile thrombocytopenia in Malwa region of India

2017 ◽  
Vol 8 (5) ◽  
pp. 83-86
Author(s):  
Vishal Yadav ◽  
Abhishek Singhai
Keyword(s):  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
General Medicine ◽  
Liver Function Tests ◽  
Emerging Diseases ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Non Hodgkin Lymphoma ◽  
Function Tests ◽  
Complete Blood Counts

Background: Febrile thrombocytopenia is the thrombocytopenia associated with fever. Diseases which commonly present with fever and thrombocytopenia are malaria, leptospirosis, septicemia, typhoid, arbovirus diseases such as dengue.Aims and Objectives: The study was intended to know the underlying etiology of febrile thrombocytopenia in Malwa region and its various presentations.Materials and Methods: This study was conducted at Department of General Medicine of a tertiary care centre for two years. Five-hundred adult patients (age >18 years) of febrile thrombocytopenia were evaluated for possible inclusion in this study. Routine investigations including complete blood counts, peripheral smear examination, kidney function tests, liver function tests, ultrasound of abdomen were done in all subjects. The specific investigations were done as and when indicated.Results: Out of 500 patients of febrile thrombocytopenia, 298 were male, while 202 were female. Commonest symptom after fever was malaise (83%) followed by nausea-vomiting (76%), headache (63.4%), jaundice (26.8%), easy fatigability (22.4%), bleeding manifestations (7.8%), cough (6.8%), dyspnea (5.8%), rash (2.4%) and delirium (1.4%). Dengue was found in 178 patients. Malaria was found in 122 patients. Other causes of febrile thrombocytopenia were septicemia (22 cases), leptospirosis (12 cases), chikungunya fever (10 cases), viral hepatitis (9 cases), enteric fever (9 cases), acute lymphoblastic leukemia (2 cases), non-hodgkin lymphoma (one case), disseminated tuberculosis (one case).Conclusion: Febrile thrombocytopenia is an important clinical condition commonly caused by infections, particularly viruses and malaria. Such studies will help in finding changing trends of locally prevalent infectious diseases and finding some new emerging diseases not prevalent in the particular region.Asian Journal of Medical Sciences Vol.8(5) 2017 83-86

scholarly journals Study of Pathway to Care among Patients with Epilepsy

2013 ◽  
Vol 1 (1) ◽  
pp. 20-25 ◽  
Author(s):  
S Subedi ◽  
PM Shyangwa ◽  
R Shakya ◽  
AK Pandey
Keyword(s):  
Tertiary Care ◽  
Complex Partial Seizure ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Generalized Seizures ◽  
The Mean ◽  
Patients With Epilepsy ◽  
First Contact ◽  
Pathway To Care

Objective: To assess the pathway to care among patients with epilepsy up to the tertiary care centre Methods: It is a hospital based, cross-sectional descriptive study of 47 patients visiting BPKIHS psychiatry OPD. Written informed consent was taken from the patients and the primary caretaker. A semi structured Performa was used to record the basic sociodemographic details. Pathway Interview Schedule developed by WHO was used to collect the data. Results Majority (66.0%) of subjects were male. Generalized Seizures were most common (76.6%) type of seizure followed by complex-partial seizure (10.6%). More than half (51.1%) first contacted dhami-jhakri for treatment of their illness. About sixty two percent of patients had the first contact with the treatment provider less than 4 yrs ago. Thirty eight percent subjects sought treatment as per advice from the family members while only 2.1% sought treatment as per advice from the healthcare worker. The most common presenting complaints were sudden loss of consciousness in 89.4%of patients. In majority of patients (57.4%), problem arised ≤ 4yrs back. Significant high numbers of patients (51.1%) were prescribed alternative forms of treatment like herbal medications, talisman, offerings and sacrifices and jhadphook for their presenting problem. About eighty seven percent patients had to travel ≤12 hours for the treatment while 10.7% had to travel a distance of >24 hrs for treatment. The mean duration that one had to travel for seeking treatment was 7.95±14.58 hours. It was found that the mean duration that one patient spend before coming to a hospital for modern treatment was 5.64 months. Conclusions People suffering from epilepsy are still using the traditional healing practices leading to delay in the patient care. These findings call for a comprehensive educational program that can remove the misconcepts regarding the illness. DOI: http://dx.doi.org/10.3126/jucms.v1i1.8418   Journal of Universal College of Medical Sciences Vol.1(1) 2013:  20-25

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