scholarly journals Anterior abdominal wall defects: Demographic and clinical profile and outcome at a tertiary care hospital

2021 ◽  
Vol 10 ◽  
pp. 20
Author(s):  
Parveen Kumar ◽  
Vivek Manchanda ◽  
Mamta Sengar
Keyword(s):  
Birth Weight ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Pediatric Care ◽  
Abdominal Wall Defects ◽  
Care Hospital

Background: The anterior abdominal defects, especially gastroschisis and omphalocele have high mortality rates in developing countries. Time to intervene has been hypothesized to be associated with morbidity and mortality. The aim was to determine factors affecting mortality in neonates with anterior abdominal wall defects. Methods: This retrospective descriptive study was done at a tertiary pediatric care center. The medical records of patients with a diagnosis of anterior abdominal defects (omphalocele/gastroschisis/umbilical cord hernia) admitted at our center from Jan 2015 to Dec 2019 were retrieved. The demographic and clinical data were studied including age, sex, religion, gestational age, associated anomalies, electrolytes at admission, septic profile, operative details, length of hospital stay, and mortality. The statistical data was fed on a Microsoft Excel worksheet and analysis was done. Results: Thirty-nine (39) neonates were included in the study. M:F ratio was 2:1, with 61.5% belonging to the Hindu religion. The majority had term gestation (87.2%). Birth weight ranged from 1.5 to 4 kg (mean 2.47 + 0.5 kg). Eighteen (18) neonates had gastroschisis, 15 omphalocele major and 6 omphalocele minor, with a median age of presentation at 1 day of life. Time to intervention ranged from 0 to 5 days (interquartile range 1-1.25 days) after admission. Primary closure could be achieved in the majority (66.7%), while ventral hernia was created in 17.9% and the silo was needed in the rest. The mean postoperative length of stay was 9.31 days (+ 9.85 days) with a survival rate of 51.3%. The mortality rate in gastroschisis and omphaloceles were 61.1% and 38.1% respectively. The significant factors for survival were time to intervene, birth weight, and primary abdominal wall closure. Conclusions: The present study brings out a different clinical profile of anterior abdominal wall defect patients. We recommend early surgery soon after stabilization and primary abdominal wall repair whenever abdominal pressures permit.

scholarly journals A rare case report of conjoined twins: Thoraco-omphalopagus with anterior abdominal wall defect

2021 ◽  
Vol 10 (4) ◽  
pp. 1724
Author(s):  
Swati Trivedi ◽  
Santosh Khokher ◽  
Shashank Trivedi ◽  
Prasoon Rastogi
Keyword(s):  
Abdominal Wall ◽  
Twin Pregnancy ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Tertiary Care ◽  
Conjoined Twins ◽  
Care Hospital ◽  
Wall Defect ◽  
Rare Case Report ◽  
Current Report

Conjoined twins are a rare deviation of monozygotic monoamniotic twins which results from fusion of the two at any part of their body. The prognosis is not good and associated with high mortality. Here we report a case of conjoined twin which was referred to our tertiary care hospital as twin pregnancy with impacted breech in obstructed labour. Taking mothers condition into account, she was taken for emergency caesarean section, performing which we realised that it was a conjoined twin. The baby were still born and conjoined at thorax and abdomen (thoraco-omphalopagus) with anterior abdominal wall defect in one and unrevealed sex in other. Current report emphasizes on making an early diagnosis of conjoined twin pregnancy, so that it can be managed at the earliest according to the gestational age.

scholarly journals OP38.08: Abdominal wall defects: evaluation of 20 cases at a tertiary care center

2011 ◽  
Vol 38 (S1) ◽  
pp. 167-167
Author(s):  
E. Simsek ◽  
E. Tarim ◽  
C. Iskender ◽  
T. Cok
Keyword(s):  
Abdominal Wall ◽  
Care Center ◽  
Tertiary Care ◽  
Abdominal Wall Defects ◽  
Tertiary Care Center

scholarly journals Management of Gastroschisis in a Tertiary Care Hospital

2013 ◽  
Vol 36 (3) ◽  
pp. 133-138
Author(s):  
MA Rashid ◽  
MM Hoque ◽  
AA Mamun ◽  
A Kabir ◽  
M Ibrahim ◽  
...  
Keyword(s):  
Birth Weight ◽  
Survival Rate ◽  
Abdominal Wall Defect ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Developed Countries ◽  
Management Plan ◽  
Care Hospital ◽  
Number Of Patients ◽  
Neonatal Icu

Background : Gastroschisis is a congenital abdominal wall defect with high mortality in developing countries. In developed countries their survival rate is more than ninety percent. This is due to appropriate information about the disease and adequate management plan. We have a good number of patients, but majority of us are lacking appropriate information about this disease. Objectives: This study was done to give some information to our medical personals about this disease and to evaluate the out come of gastroschisis in relation to birth weight, age of neonate and procedure of closure of the defect. Methodology: This prospective observatinal study was done in the surgery department of Dhaka Shishu Hospital (DSH) in a period of two years. All gastroschisis patients admitted during this period were enrolled and their mortality were analyzed in relation to weight, age and operative procedure. Minimal intervention management of gastroschisis (MIMG) were performed in suitable cases. Results: A total of 32 patients were admitted. Mortality were significantly high among the VLBW babies than babies whose birth weight > 1500 gm (88.9% vs17.4%) and those who were admitted after 24 hours of age than who admitted before 24 hours of age (66.7% vs26.1%). Overall survival rate was 62.5% and after surgery 71.5%. Conclusion: Gastroschisis is not rare in our population. Birth weight, early hospitalization with primary closure as early as possible, proper selection of patient for MIMG effect outcome. Adequate supportive measures like TPN, neonatal ICU and information about the disease will further increase the survival rate. DOI: http://dx.doi.org/10.3329/bjch.v36i3.14276 BANGLADESH J CHILD HEALTH 2012; VOL 36 (3) : 133-138

scholarly journals Clinical Profile, Outcome and Risk Factors for Mortality of Neonates Requiring Mechanical Ventilation at Tertiary Care Centre of Central Gujarat, India

2021 ◽  
Vol 41 (1) ◽  
pp. 29-34
Author(s):  
Pareshkumar A Thakkar ◽  
Himanshu G Pansuriya ◽  
Sheela Bharani ◽  
Khushboo Kamal Taneja
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Pulmonary Haemorrhage ◽  
Adverse Outcomes ◽  
Clinical Profile ◽  
Care Hospital

Introduction: Mechanical ventilation is an important factor contributing to the reduced neonatal mortality in NICU. However, many ventilated babies are left with detrimental sequelae. This study was undertaken to know the prognostic predictors and survival outcome in the ventilated neonates. We assessed the clinical profile, outcome of mechanical ventilation and analysed the risk factors for mortality and complications resulting from mechanical ventilation. Methods: A prospective study was conducted at the NICU of a tertiary care hospital in India. The study period was from May 2015 to April 2016. Neonates who underwent mechanical ventilation and met the inclusion criteria were enrolled in the study. Their demographic profile, outcomes and risk factors were documented and analysed using appropriate statistical methods. Results: 285 neonates required mechanical ventilation during the study period. Among them, 190 were included in the study. Overall mortality was 99 out of the 190 enrolled (52%). The most common indications for mechanical ventilation were Respiratory Distress Syndrome (RDS), Meconium Aspiration Syndrome (MAS) and apnea. Risk factors contributing significantly to higher mortality of ventilated neonates were very low birth weight (VLBW), gestation of less than 32 weeks, shock, ventilator- associated complications like pneumothorax and pulmonary haemorrhage. In multiple regression analysis, very low birth weight, circulatory disturbances, pneumothorax, pulmonary haemorrhage, and higher initial FiO2 requirement were found to be independent risk factors of mortality. Conclusions: The commonest indications for mechanical ventilation were RDS and MAS. Significantly higher mortality was seen amongst VLBW, preterm neonates. Co-morbidities like circulatory disturbance, and complications like pneumothorax and pulmonary haemorrhage contributed to adverse outcomes.

scholarly journals CLINICAL PROFILE AND PREDICTORS OF MORTALITY OF EXTRAMURAL NEONATES ADMITTED IN NICU OF TERTIARY CARE HOSPITAL IN CENTRAL RAJASTHAN : PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
pp. 119-122
Author(s):  
Abhilasha Sharma ◽  
Pukhraj Garg ◽  
Arjun Singh
Keyword(s):  
Birth Weight ◽  
Neonatal Sepsis ◽  
Neonatal Period ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Essential Newborn Care ◽  
Predictors Of Mortality

OBJECTIVE: This study was undertaken to know the clinical profile and predictors of mortality of outborn neonates admitted in Neonatal Intensive Care Unit (NICU). METHOD:This prospective study was conducted in NICU of department of pediatrics,JLN medical college & hospital, Ajmer from January 2019 to December 2019. RESULTS:Of the 2250 neonates admitted,There was male preponderance (64%),male:female ratio was 1.78:1.Majority of neonates (68.4%) were term while 31.2% were preterm and 0.4% were post term gestation. Majority of neonates (79.8%) were admitted in early neonatal period while 20.1% neonates were admitted in late neonatal period. As per birth weight,44.1% neonates were between 1.5-2.49 kg,42.6% neonates had birth weight more than 2.5 kg while 3.4% neonates were <1 kg.Majority of neonates (88.7%) were delivered vaginally while 11.3% were delivered by caesarean section.Majority of neonates (85.1%) were delivered at govt.hospitals while 11% and 3.9% neonates were delivered at private hospitals and at home respectively. Rural residency (73.7%) was far more as compared to urban residency (26.3%).42.8% mothers had primary education and 47.7% mothers had secondary education while 3.8% mothers were illiterate. Majority of cases (66.1%) belonged to middle socioeconomic class. Major causes of NICU admission were birth asphyxia / HIE of newborn (21.11%),neonatal sepsis (16.36%),neonatal jaundice (12%),RDS of newborn (8.6%), and prematurity (7.7%). Out of 2250 neonates admitted, 70.1% babies were successfully discharged while 29.9% neonates died during treatment.Birth Asphyxia / HIE of Newborn (22.25%),RDS of Newborn (20.47%),Neonatal Sepsis (16.02%), Shock (10.98%), Congenital Malformations (6.82%), and ELBW (6.38%) were found to be major causes of mortality among neonates admitted in NICU. CONCLUSION: The majority of morbidities and subsequently the mortalities can be reduced by improving maternal care and essential newborn care,appropriate primary interventions and timely referral to tertiary care centers for high risk cases,with better transport facilities for sick neonates.

scholarly journals Analysis of clinical profile and prescription pattern of malaria in a tertiary care hospital in Karnataka, India

2019 ◽  
Vol 8 (8) ◽  
pp. 1744
Author(s):  
Raghu Murthy N. ◽  
Seema Rai
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Clinical Profile ◽  
Response To Treatment ◽  
Care Hospital ◽  
Peripheral Smear ◽  
Artemisinin Derivatives ◽  
Health Care Center ◽  
Severe Type

Background: Malaria is one of the leading causes of morbidity and mortality in developing countries like India. Plasmodium falciparum and Plasmodium vivax are the commonest species implicated for an increased incidence of malaria in India. The pattern of disease, signs, and symptoms vary from place to place, region to region due to demographic variations. The current study was undertaken to study the differences in the clinical profile of malaria, particularly signs and symptoms, complications and response to treatment in malaria.Methods: A retrospective, single center, surveillance study was carried out at a tertiary health care center in Mangalore. All patients aged above 18 years diagnosed as malaria by peripheral smear method and rapid diagnostic tests were included in the study. The clinical features, complications, and response to treatment were noted.Results: Fifty eight patients diagnosed as malaria were included in the study. Compared to other studies and nationwide incidences, here P. vivax emerged as the leading cause of malaria. All patients presented with fever varying from 3-20 days. About 30 patients complained of headache and 21 patients presented with malaise. In about 6 patient’s complications were seen. Majority of patients received artemisinin derivatives followed by chloroquine for treatment of malariaConclusions: Previous thinking that complications are only seen with P. falciparum has to be changed. Now many complications, mild as well as severe type are seen in P. vivax malaria. Drug resistance is another global problem which needs to be tackled wisely by systematic usage of antimalarials.

scholarly journals Clinical Profile of Hoarseness of Voice: A Hospital-Based Cross-Sectional Study

2021 ◽  
Author(s):  
Nitin Deosthale ◽  
Asha Jadia Soni ◽  
Sonali Prabhakar Khadakkar ◽  
Mateen Khursheed Wani ◽  
Kanchan Sandeep Dhote ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Care Hospital ◽  
Sectional Study ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Male Preponderance

Abstract Introduction Hoarseness is a symptom with a varied etiology ranging from inflammatory condition, benign lesions to malignant lesions. Benign conditions are more common than malignant. Proper knowledge of clinical profile and evaluation is necessary to treat the cause. Objective It was conducted with the aim to study the clinical profile of patients with hoarseness of voice. Materials and Methods It was a descriptive cross-sectional study of 2 years conducted at Department of ENT at Tertiary Health Care Hospital, India. Patients aged above 10 years presenting with hoarseness of voice were included in the study. After detailed history related to sociodemographic particulars, clinical examinations including Hopkin’s rod examination in all patients and direct laryngoscopy, and radiological and histopathological examination were performed whenever indicated. Results Out of total 100 patients, maximum patients (32%) were in the age group of 21 to 30 years. There was slight male preponderance with male:female ratio of 1.17:1. Laborer (29%) was the major group affected in terms of occupation. Most common predisposing factor was smoking (35%). Commonest etiology for hoarseness of voice was chronic laryngitis (20%). Conclusion Hoarseness of voice as a symptom should never be ignored as its etiology may range from simple infection to malignancy. At our tertiary care center majority of patients come from rural area. Most of the etiological factors found in our study were treatable medically or surgically. Early diagnosis is the key to improve the outcome of treatment.

scholarly journals Clinical profile of dehydration fever in neonates in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 718
Author(s):  
Muhammad Hassan ◽  
Adarsh E. ◽  
Rajanish K. V.
Keyword(s):  
Weight Loss ◽  
Birth Weight ◽  
Urine Output ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Factors Affecting ◽  
Medical College ◽  
Significant Difference ◽  
Daily Urine

Background: The aim of this study was to determine the clinical profile of neonates admitted with dehydration fever and ascertain the maternal and neonatal factors affecting it.Methods: A observational descriptive study was conducted at Rajarajeswari Medical College and hospital, population included neonates who were admitted in NICU with dehydration fever.Results: The study were conducted among 50 neonates admitted with dehydration fever. Majority of neonates (72%) were diagnosed with dehydration fever on day 3 of life. 84 % neonates were born to primiparous mothers. In the study there was significant difference in mean birth weight, weight at admission and percentage of weight loss between birth weight and weight at admission with respect to symptoms on presentation. Mean % of weight loss was 12.06 when dehydration fever was presented with fever, 11.29 when dehydration fever presented with decreased urine output, 18.44 when presented with both fever and decreased urine output and 12.73 when presented with jaundice these values were statistically significant.Conclusions: Dehydration fever occurs most commonly on day 3 or after, effective measures should be initiated for early diagnosis and prevention of complications like effective breast-feeding counselling, proper techniques, good latching and supplementation of artificial feeds if required and monitoring of daily weight and daily urine output.

scholarly journals Demographic variables and clinical profile of scrub typhus patients: experience from a tertiary care center in Udaipur, Rajasthan

2021 ◽  
Vol 8 (12) ◽  
pp. 5814
Author(s):  
Suresh Chaudhary ◽  
Mukul Dixit ◽  
Anjana Verma ◽  
Hemlata Mittal ◽  
Medha Mathur
Keyword(s):  
Rural Areas ◽  
Scrub Typhus ◽  
Care Center ◽  
Tertiary Care ◽  
Demographic Variables ◽  
Clinical Profile ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Effective Strategies ◽  
Patients Experience

Background: Scrub typhus is an acute febrile bacterial zoonoses, caused by Orientia tsutsugamushi and is associated with a range of complications, including sepsis, Acute respiratory distress syndrome (ARDS), pre-renal azotemia and Multiorgan dysfunction syndrome (MODS). The objective of this study was to study the demographic variables and clinical profile of the patients diagnosed with scrub typhus. admitted in a tertiary care hospital in Udaipur, Rajasthan.Methods: It was a longitudinal, observational study, conducted in a tertiary care centre in Udaipur, Rajasthan from January 2020-June 2021. All patients, diagnosed (positive for antibody IgM) with scrub typhus in the hospital during the study period were included in the study. Information about the patients was collected using a pre-tested questionnaire and clinical examination, after taking the informed consent from the study participants.Results: Mean age of the patients was 36.4±19 years. Majority (69.4%) of the patients were from rural area and fever was the most common (83.9%) symptom experienced. Eschar was found in only 1.6% of patients. About 87.1% of the patients had complications, with MODS, being the most common affecting about 34% of the total patients. The patients from rural areas were found to have significantly higher odds (OR=1.61) of having complications as compared to urban area patients (CI=1.09-4.3).  Conclusions: This article draws attention to the fact that scrub typhus is quite on rise and most of the cases are associated with complications. There is a need to develop effective strategies and interventions to stop this rampant rise of the cases in India. 

scholarly journals Comparative Cellular Local Response in Abdominal Defect Plastic Surgery with Bovine Pericardium and Bovine Fascia Preserved in Formaldehyde in Experimental Rabbits

2017 ◽  
Vol 23 (2) ◽  
pp. 83-93
Author(s):  
Eva Gudemac ◽  
S. Babuci ◽  
C. Tica ◽  
V. Petrovici ◽  
V. Nacu ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Direct Contact ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Bovine Pericardium ◽  
Congenital Defects ◽  
Abdominal Wall Defects ◽  
Wall Defect ◽  
Fascia Graft ◽  
Subcutaneous Layer

AbstractIn the present paper, we refer to a method of primary closure of congenital defects of the anterior abdominal wall with tensionless viscero-abdominal disproportion. The study group included 10 animals subjected to surgery of the abdominal wall defect closure with bovine pericardium graft preserved in 0.5% formaldehyde, and 5 rabbits of the same breed and weight, in which bovine fascia graft was used as implant, being preserved in 0.5% formaldehyde. The abdominal anterior wall defect was made surgically by excision of the musculo-fascial structures and peritoneum. Bovine pericardium graft and bovine fascia graft were placed and fixed posteriorly to rectus abdominals muscles, having direct contact with the intra-abdominal contents and protected by suturing skin and subcutaneous layer.The purpose of the study was to perform a comparative postoperative evaluation of local macroscopic and microscopic changes that develop after reconstruction of the major abdominal wall defects experimentally induced in rabbits, using bovine pericardium and bovine fascia grafts preserved in 0.5% formaldehyde.In cases of major fascial defects of the anterior abdominal wall, bovine pericardium graft has acceptable strength and biocompatibility, having stabilizing properties of the abdominal wall due to the development of the connective tissue layer located between the implant and the subcutaneous layer. Bovine fascia grafts preserved in formaldehyde have an insignificant irritating and inflammatory action on the intestinal loops compared with bovine pericardium, and do not induce the development of a significant abdominal adhesion process, this allowing their use in the abdominal fascial defects closure with placement in direct contact with the abdominal contents.

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