scholarly journals FREQUENCY AND CAUSES OF PERINATAL MORTALITY IN A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

2018 ◽  
Vol 16 (1) ◽  
pp. 15-19
Author(s):  
Maimoona Qadir ◽  
Sohail Amir ◽  
Samina Jadoon ◽  
Muhammad Marwat
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Mortality Data ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical Disorders ◽  
Perinatal Mortality Rate

Background: Perinatal mortality rate indicates quality of care provided during pregnancy and delivery to the mother and to the neonate in its early neonatal period. The objective of this study was to determine the frequency and causes of perinatal mortality in a tertiary care hospital in Peshawar, Pakistan. Materials & Methods: This cross-sectional study was conducted at Department of Gynaecology & Obstetrics, Khyber Teaching Hospital, Peshawar, Pakistan from 1st January 2016 to 31st December 2016. The inclusion criteria was all singleton gestation with gestational age of at least 24 weeks presenting with perinatal mortality. Data was collected for the following variables; age groups (up to 20 years, 21-30 years, 31-40 years and > 40 years), booking status (yes/ no), period of gestation (24-31+6, 32-36+6, 37-39+6 and > 40 weeks), Foetal weight ( 3.5 kg) and cause of perinatal mortality. Results: Out of 4508 deliveries there were 288 perinatal deaths, including 228 stillbirths and 60 neonatal deaths, so perinatal mortality rate was 63.8/1000 births. 90.28% women were unbooked. Most common cause was hypertensive disorders of pregnancy (27.78%) followed by antepartum haemorrhage (25.71%) and then mechanical causes (13.88%). Congenital anomalies comprised 11.8% cases, neonatal problems 10.07% and maternal medical disorders for 4.16% cases. Cause of 4.16% cases remained unexplained. Conclusion: Appropriate strategies like control of identifiable causes, proper antenatal and postnatal care, healthy delivery practices and availability of emergency neonatal care facilities can bring down perinatal mortality rates.

scholarly journals Composite index of anthropometric failure among under 5 children attending the Immunoprophylaxis clinic in a tertiary care hospital in Nagpur, Maharashtra, India

2018 ◽  
Vol 5 (3) ◽  
pp. 888
Author(s):  
Abhijit Kherde ◽  
Chaitanya R. Patil ◽  
Jyotsna Deshmukh ◽  
Prithvi B. Petkar
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Composite Index ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Study Data ◽  
Care Hospital ◽  
Global Public Health ◽  
Cross Sectional

Background: Under nutrition is a global public health problem. There are numerous methods of assessment of malnutrition among which CIAF is the most recent, relatively robust since it envisages all the parameters for estimation of nutritional status of the children. So, this study was conducted to find the rates of composite index of anthropometric failure in the children attending the Immunoprophylaxis clinic in a tertiary care hospital of Nagpur and to find associations with the socio demographic variables.Methods: This descriptive cross-sectional study was conducted at the Immunoprophylaxis clinic of a tertiary care institute in Nagpur from September 2016 to January 2017. The study subjects were the children attending the OPD of Immunoprophylaxis clinic of a tertiary care hospital. Necessary permissions were taken before the start of the study. Data was collected using pretested and pre-designed questionnaire. Height and weight were measured using standard guidelines and categorized into groups of CIAF as described by Nandy et al.Results: A total of 460 study subjects were enrolled in the study. The mean age group of the study subjects was 2.47±1.56 years. According to the grades of CIAF, 48.51% were having no failure. Age and gender were factors which were associated with failure status by CIAF.Conclusions: We found high rates of anthropometric failure in our study. The age groups less than 3 years had higher odds of being in failure when compared to more than 3 years age. Further, males had higher odds of being into failure when compared to females. Community based studies are recommended.

scholarly journals Trends and Determinants of Perinatal Mortality in a Tertiary Care Hospital of Nepal

2021 ◽  
Vol 20 (1) ◽  
pp. 77-82
Author(s):  
Yuba Nidhi Basaula ◽  
Radha Kumari Paudel ◽  
Ram Hari Chapagain
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Neonatal Sepsis ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Perinatal Mortality Rate ◽  
Increasing Trend

Introduction: Perinatal mortality rate (PMR) in Nepal is still very high. In major hospitals of Nepal, it is still ranging from 20 to 30 per thousand births. This study was carried out to review the different aspects of PMR and classifying them and identify the causes of perinatal and neonatal deaths and assessing the need for improvement in quality of pregnancy and newborn care. Methods: It was a retrospective study carried out in Bharatpur Hospital, Chitawan, Nepal. Data of all stillbirths from 22 weeks of pregnancy and neonatal deaths up to seven days of life was taken from monthly perinatal audit and annual mortality review. The data was taken from July 2017 to Jun 2019. All the perinatal deaths were then classified. Results: Over a two year period, there were total 25,977 births and total death was 369. Thus perinatal mortality rate was 12.3 per thousand births. Still births (fresh and macerated) contributed almost 82.4% of the perinatal deaths and neonatal death contributed 17.6% of total deaths. Deaths related to unexplained intrauterine fetal death (IUFD) showed an increasing trend and have increased by more than 20% in past two years from 39.1% to 60.8%. Deaths due to perinatal asphyxia, neonatal sepsis, respiratory distress syndrome and extreme prematurity were increased. Conclusions: PMR over the two years has shown increasing trend at our institute. There is need to improve antenatal, obstetric as well as intra-partum services to further reduce the still birth as well as deaths due to prematurity, RDS, neonatal sepsis and perinatal asphyxia.

scholarly journals Clinical Symptoms, Pathogen Spectrum, Risk Factors and Antibiogram of Suspected Neonatal Sepsis Cases in Tertiary Care Hospital of Southern Part of Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Bijay Raj Pandit ◽  
Ashish Vyas
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Neonatal Mortality Rate ◽  
Cross Sectional

Introduction: Neonatal mortality rate is highest in sub-Saharan Africa and Southern Asia region. The present study is undertaken to find out prevalence of neonatal sepsis, recognize bacterial pathogens, neonatal risk factors, major symptoms, and their antibiotic sensitivity pattern in neonates in tertiary care hospital in southern Nepal. Methods: A descriptive cross-sectional study was carried out in a tertiary care hospital from 2nd January 2017 to 20th February 2018 after approval (Ref: 125/2016-17). The sample size was calculated and convenience sampling was done. Data were collected from hospital records and microbiology laboratory and analyzed by Statistical Package for Social Sciences. Results: Out of 1200 clinically suspected cases, early-onset neonatal sepsis was seen in 290 (79.89%). A positive culture was seen in 363 (30.25%) where maximum bacterial growth was found in 254 (69.98%) males. Preterm gestational age was seen in 265 (73%), low birth weight 284 (78.23%), a vaginal delivery mode in 279 (76.90%), and delivery in hospital in 232 (63.91%). Likewise, Staphylococcus aureus in 229 (63.08%) was found maximum followed by Klebsiella pneumoniae in 48(13.22%). The major symptom observed was Respiratory distress in 245 (20.41%) while culture positive was seen in poor cry in 94 (53.10%). Mainly effective antibiotics against Gram-positive and gram-negative organisms were Linezolid in 250 (94%) and Imipenem in 46 (90.19%), whereas Penicillin-G in 254 (99.21%) and Ampicillin in 38 (94.74%) found resistance towards organisms respectively. Conclusions: The high prevalence of neonatal sepsis in our study reflects a huge challenge to reduce the neonatal mortality rate to 12 by 2030 of Sustainable Development Goals. Bacterial isolates exhibited higher resistance towards commonly used antibiotics.

scholarly journals Clinicodemographic Profile of Children with Seizures in a Tertiary Care Hospital: A Cross-Sectional Observational Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Nagendra Chaudhary ◽  
Murli Manohar Gupta ◽  
Sandeep Shrestha ◽  
Santosh Pathak ◽  
Om Prakash Kurmi ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Age Groups ◽  
Idiopathic Epilepsy ◽  
Care Hospital ◽  
Partial Seizures ◽  
Cross Sectional ◽  
Mortality And Morbidity

Seizures are one of the common causes for hospital admissions in children with significant mortality and morbidity. This study was conducted to study the prevalence and clinicodemographic profile of children with seizures in a tertiary care hospital of western Nepal. This prospective cross-sectional study conducted over a period of 2 years included all admitted children (2 months–16 years) with seizures. Among 4962 admitted children, seizures were present in 3.4% (n=168) of children, with male preponderance. 138 (82.1%) children had generalized tonic-clonic seizures (GTCS) and 30 (17.9%) children had partial seizures. GTCS were more common than partial seizures in both sexes (male = 82.7%; female = 81.2%) and age groups. There was no statistical significance in the distribution of seizures (GTCS and partial seizures) with sexes (P=0.813) and age groups (P=0.955). Mean ages of children having GTCS and partial seizures were 8.2±4.6 years and 8.2±4.2 years, respectively. Loss of consciousness (55.4%), fever (39.9%), vomiting (35.1%), and headache (16.1%) were common complaints in seizure patients. Significant number of GTCS cases had fever (P=0.041) and neurocysticercosis (n=72; 43%) was the most common etiology in seizure patients. Idiopathic epilepsy (38 (22.6%)), meningoencephalitis (26 (15.5%)), and febrile convulsions (14 (8.33%)) were other leading disorders in children with seizures.

scholarly journals Rational and irrational use of intra-venous infusions: a cross-sectional study among patients of a tertiary care hospital

2019 ◽  
Vol 6 (4) ◽  
pp. 1286
Author(s):  
Amber G. ◽  
Muhammad J. Khan ◽  
Amina K. ◽  
Warda G. ◽  
Murtaza G. ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adult Age ◽  
Significant Difference

Background: Intravenous infusions (IV) are a rapid mean of administering drugs. Hospitals are commonplace for their use, but at the same time they have many serious potential complications. This study aims to know the justified use of intravenous infusion among patients of a tertiary care hospital and awareness about its use.Methods: It was a cross-sectional study in which 249 subjects were conveniently studied. Nil per oral, severity of dehydration, vomiting, and diarrhoea was used as confirmatory criteria for using IV Infusions. Questionnaire with verbal consent was used to collect the data. Descriptive statistical analysis was applied to analyse the data and presented as means, frequencies and percentages in the form of tables and figure.Results: Total n249 (100%) subjects, n68 (27.3%) males and n181 (72.7%) females with average age was 24.05±14.21 years participated. Among n116 (46.6%) irrational users, females n76 (30.5%) were more then males n40 (16.1) with significant difference, p= 0.018. However, no significant difference was found among other variables (age groups, profession, education, awareness and rational or irrational use of IV infusion). Majority n249, n204 (81.9%) were not aware of the IV infusion medication error and doctors were most common unjustified prescribers of IV infusion, n105 (90.5%).Conclusions: The study concluded with the more prevalent irrational IV infusion use in our setup. Doctors appeared the dominant prescriber of irrational IV infusion. This statement is astonishing and must not be overlooked. Female gender, adult age, under-grade patients and students are more exposed to irrational IV infusion.

scholarly journals Normative Orbital Measurement Based on Computed Tomography Imaging in Tertiary Care Hospital, Bangalore, Karnataka

2021 ◽  
Author(s):  
Anitha Kini ◽  
Sanket Vinubhai Davra
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Hospital ◽  
Ct Scanner ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Left Orbit

Introduction: The orbit is an anatomically complex region. Clear idea of the normal orbital measurements is needed for the diagnosis and management of the various diseases that may affect the orbit like optic neuritis, optic nerve glioma, meningioma, proptosis and exophthalmos. Aim: To evaluate normative orbital measurement at tertiary care hospital in Bangalore, Karnataka in Indian population based on Non Enhanced Computed Tomography (NECT) imaging. Materials and Methods: A cross-sectional observational study of 100 patients referred to a tertiary care centre for NECT of the brain for diseases other than those of the orbits was conducted. Patients having any orbital disorder, surgery or trauma and having metallic implants were excluded from the study. The patients of all age groups and either sex were included. The horizontal orbital diameter, vertical orbital diameter, orbital index, optic nerve complex, globe position, interorbital diameter and interzygomatic line measurements were calculated for 100 patients, i.e., total of 200 orbits using both axial and direct coronal CT images. Mean measurements of these parameters were calculated. Scans were performed on Siemens Somatom Perspective 128 slice multi- detector CT scanner. All statistical analysis was performed using Statistical Package for The Social Sciences (SPSS) for windows software (SPSS Inc. Illinois, Chicago, USA). Results: The mean orbital index was 118.6 and 118.3 for right and left orbit, respectively. It was derived from mean horizontal orbital diameter of 32.5 mm and 31.7 mm of right and left orbit, respectively and mean vertical orbital diameter of 38.4 mm and 37.4 mm of right and left orbit, respectively. Mean optic nerve sheath complex diameter was 5.2 mm and 5.4 mm for right and left orbit, respectively, while mean globe position measurements 6.7 mm and 6.8 mm of right and left orbit, respectively. Average interorbital distance was 22.9 mm and average interzygomatic distance 97.1 mm. Conclusion: The present study has given normative mean measurements for various orbital structures that are essential to ophthalmologists and radiologists to differentiate normal from abnormal dimensions which is likely to be helpful in accurate assessment of various orbital pathologies.

scholarly journals An Analysis of Causes and Avoidable Factors of Perinatal Deaths at Tertiary Care Hospital

2021 ◽  
Vol 4 (1) ◽  
pp. 424-428
Author(s):  
Sunita Bhandari ◽  
Yam Dwa ◽  
Riya Sharma
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Seek Health Care ◽  
Danger Signs ◽  
Perinatal Mortality Rate ◽  
Antenatal Counseling

Introduction: Perinatal deaths are potentially preventable and reflect the quality of care provided in the prenatal period, during labor, and to a newborn. The purpose of this study was to assess the causes and avoidable factors contributing to perinatal deaths in the year 2018-19 and compare these with the previous two years at Tertiary Care Hospital.Materials and Methods: This study was conducted from a retrospective analysis of all stillbirths and early neonatal deaths in the year July 2018 to July 2019. The Perinatal Mortality Rate, causes, and avoidable factors leading to perinatal deaths were analysed during this year and were compared with that of the previous two years at KIST Medical College and Teaching hospital.Results: PMR was 16.09 per 1000 births in the year 2018-19. Previous two studies at this hospital in the year 2017-18 and 2016-17 showed a Perinatal Mortality Rate of 14.61 and 16.27/1000 births respectively. The commonest primary cause of perinatal deaths was intrapartum hypoxia 6 (30%), preterm delivery 5 (31.25%), and congenital anomalies4 (19%) during the year 2018-19, 2017-18, and 2016-17 respectively. The most common avoidable factors identified were a maternal delay to seek health care, inadequate antenatal checkups, and inadequate antenatal counseling of danger signs by a service provider over the last three years.Conclusions: Maternal delay to seek health care and lack of maternal knowledge of danger signs during pregnancy were the common avoidable factors identified. More efforts should be made to raise awareness of pregnant women during antenatal care visits regarding early healthcare-seeking behavior when needed.

scholarly journals Perinatal Mortality Review in a Tertiary Care Hospital: Way Forward to Address SDG Health Goal 3

2019 ◽  
Vol 18 (1) ◽  
pp. 69-74
Author(s):  
Manisha Bajracharya ◽  
Ang Tshering Sherpa ◽  
Ajay Dhakal ◽  
Sunita Bhandari ◽  
Heera Tuladhar ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Congenital Anomalies ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Well Being ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Perinatal Mortality Rate

Introduction: Sustainable development goal 3 targets at ensuring healthy lives and promoting well-being for all at all ages. One of the component for achievement of this goal is improvement of maternal and child health; the indicators of which is perinatal mortality rate. The aim of this study was to evaluate the cause of perinatal death in a tertiary care medical centre, which may help to reduce the incidence of perinatal death and improve the quality of care. Methods: A prospective study was done over a period of one year from April 2016 to March 2017. Causes of perinatal deaths based on PSANZ classification were recorded along with patients demographics and also avoidable factors were evaluated. Results: Out of total 1275 deliveries, there were 21 perinatal deaths including three intrauterine foetal deaths, one still birth and seven early neonatal deaths. The perinatal mortality rate was 16.27 per 1000 birth. Majority of perinatal deaths (19%) occurred due to congenital anomalies followed by (14%) hypertensive disorder in pregnancy, intrapartum hypoxia (14%), unexplained causes (14%), 9.5% cord prolapse, antepartum haemorrhage (9.5%), 5% due to intrauterine growth restriction, gestational diabetes mellitus or preterm labour. Most of the mothers whose baby had perinatal deaths had ANC outside. Most of the deaths occurred in between gestational age of 37 to 41 weeks. Perinatal mortality was more in multigravida. Delay to seek health care and inadequate antenatal checkups were the most common avoidable factors. Conclusions: Congenital anomalies and hypertensive disorders during pregnancy were the most common causes of perinatal death. Delay in health seeking behaviour was the most common avoidable factors for perinatal death. We recommend early identification of high risk pregnancy through proper antenatal screening, educating pregnant women to identify danger signs of pregnancy, creating public awareness about importance of antenatal checkups, vigilant labour monitoring for foetal distress, to reduce some categories of deaths.  

scholarly journals Job satisfaction among doctors of a tertiary care hospital of eastern India

2016 ◽  
Vol 6 (3) ◽  
pp. 595-602 ◽  
Author(s):  
Sharmistha Bhattacherjee ◽  
Kuntala Ray ◽  
Jayanta Kumar Roy ◽  
Abhijit Mukherjee ◽  
Hironmoy Roy ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Eastern India ◽  
Cross Sectional ◽  
Level Of Satisfaction

Background: Job satisfaction expresses the extent of congruence between an individual’s expectation of the job and the reward that the job provides. Job satisfaction among doctors is an issue that is of utmost importance because of factors like patient relationships and time pressures associated with managed care. The current study was done to determine the level of job satisfaction in doctors posted in a tertiary care hospital of eastern India and to find out the factors associated with it.Materials and Methods: A descriptive cross sectional study was conducted among 255 doctors posted in a tertiary care hospital of eastern India. Data were collected using a self-reported questionnaire consisting of 49 items addressing the seven domains of job satisfaction, where higher values indicated higher level of satisfaction. The average scores of items were computed to construct factor scores for each individual. Two stage cluster analysis was performed to get the proportion of satisfied doctors and binary logistic regression was used for comparison of predictors of job satisfaction.Results: The proportion of job satisfaction was found to be 59.6% and the most important factor was found to be working space. On adjustment, the odds of being satisfied were found to be higher in the older age groups, among males, doctors posted in preclinical or paraclinical departments and those staying in present setting for 5 years or more.Conclusion: More than half of the doctors were found to be satisfied with their job which can help the policy makers to make necessary strategies to increase the level of satisfaction of the employees.

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