scholarly journals Subarachnoid haemorrhage from Spinal Dural Arteriovenous Fistula in a child

2018 ◽  
Author(s):  
Narindra Ramnarine ◽  
Patrick Knight ◽  
Devindra Ramnarine
Keyword(s):  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Cerebral Aneurysms ◽  
Paediatric Population ◽  
Care Hospital ◽  
Spinal Dural Arteriovenous Fistula ◽  
Common Cause

SAH in the paediatric population is an uncommon entity accounting for 1-2% of SAH in all age groups & only 18% of ICH in the paediatric population. Trauma is the most common cause of isolated SAH in the paeditric population, with ruptured intracerebral aneurysms although still rare, being the most common cause of spontaneous SAH in children. AVMs are uncommon source of spontaneous SAH. Although they are 10 times more common than cerebral aneurysms in the paediatric population, they rarely present with isolated SAH. This report aims to present such a rare case presented to a tertiary care hospital in Trinidad.

scholarly journals A Comparative Analysis of Outcomes of Conventional Cold Dissection Versus Laser Tonsillectomy in Pediatric Cases in a Tertiary Care Hospital in Haryana

2021 ◽  
Author(s):  
Amit Kumar ◽  
Surender Kumar ◽  
Anand Krishnan ◽  
Manish Verma ◽  
Uma Garg ◽  
...  
Keyword(s):  
Operative Time ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Paediatric Population ◽  
Care Hospital ◽  
Secondary Complications ◽  
Post Operative Pain ◽  
Secondary Bleeding ◽  
Paediatric Age ◽  
Cold Dissection

AbstractTonsillectomy is one of the commonest ENT procedures done in paediatric population, the technique of which has evolved over years to decrease the morbidity associated with the surgery. This prospective randomized comparative study is done to evaluate the efficacy of two different techniques of this surgery, conventional cold dissection and laser tonsillectomy based on operative time, blood loss, post-operative pain and occurrence of secondary complications. The study was done in 68 patients of paediatric age group, 34 in each group underwent cold dissection and laser tonsillectomy. Operative time and bleeding were significantly low for laser group. Pain score was comparable in early post-operatives days, but was high towards the end of first week. Our study reported only one incidence of complication in the form of a secondary bleeding.

scholarly journals A rare case of subcutaneous dirofilariasis from a tertiary care hospital in Western Maharashtra

2021 ◽  
Vol 14 (1) ◽  
pp. 80
Author(s):  
Shahzad Mirza ◽  
NageswariR Gandham ◽  
NikunjaK Das ◽  
RabindraN Misra
Keyword(s):  
Rare Case ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Impact of Running a Behavior Therapy Room for Various Categories of Urinary Incontinence Cases in Different Age Groups in Obstetrics-Gynecology Outpatient Department of a Tertiary Care Hospital

2014 ◽  
Vol 48 (4) ◽  
pp. 159-163
Author(s):  
Vanita Jain ◽  
Puja Dudeja
Keyword(s):  
Urinary Incontinence ◽  
Behavior Therapy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Outpatient Department ◽  
Care Hospital ◽  
Kegel Exercises ◽  
Therapy Room ◽  
Trained Staff

ABSTRACT Introduction Urinary incontinence (UI) affects > 60% women. Its management is simple with the use of Kegel exercises. However, very few studies have been done in India about this problem and its solution. Objective To assess the impact of running a behavior therapy room (BTR) for various categories of UI cases in different age groups in obstetrics gynecology outpatient department (OBG-OPD) of a tertiary care hospital. Materials and methods Patients of UI were referred from gynecology OPD to BTR. There was trained staff available in BTR to teach Kegel exercises and related behavior therapy to the patients. Records of the patients were maintained. Follow-up was done through phone calls and personal visits of UI patients. Results A total of 251 cases were registered in BTR over 2 years. Overall 126 patients got relief from urine incontinence and prolapse of pelvic floor organs after BT. Conclusion Establishment of a separate room (BTR) with trained staff can be done in OBG department to teach Kegel exercises and to provide relief to women suffering from UI and pelvic organ prolapse (POP). Recommendation Behavior therapy room should be established in gynecology OPDs of all hospitals. How to cite this article Kaur T, Dudeja P, Sharma M, Jain V, Singh A. Impact of Running a Behavior Therapy Room for Various Categories of Urinary Incontinence Cases in Different Age Groups in Obstetrics-Gynecology Outpatient Department of a Tertiary Care Hospital. J Postgrad Med Edu Res 2014;48(4):159-163.

scholarly journals Discomforts in Critically ill Patients: Our Experience in Intensive Care Unit of a Tertiary Care Hospital in India

2021 ◽  
Author(s):  
Reetu Verma ◽  
Sasmita Panda ◽  
Rajeev Kumar Nishad
Keyword(s):  
Intensive Care ◽  
Environmental Factors ◽  
Critically Ill ◽  
Nursing Care ◽  
Critically Ill Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Icu Patients ◽  
Common Cause

Introduction: Patients admitted in the Intensive Care Units (ICUs) experiences various discomforts which may be recognised or unrecognised. These discomforts may arise from the environment, may be related to the ICU care and discomfort related to the health status of the patient and critical care interventions. Aim: To identify the various discomforts in ICU patients, to classify them with respective causes, identify the most common cause among them and whether ICU sedation helps in reducing discomforts. Materials and Methods: This observational study was conducted from 15th July to 15th October 2018 on 120 mixed ICU patients in a Tertiary Care Hospital in India. Patients who were admitted to ICU for more than 24 hours, aged 18 years and above, those who gave written informed consent were observed and enquired for any discomfort. Discomforts have been identified and recorded by a fulltime intensivist by direct observation, by interacting with the patients and asking the family members and others (indirect approach). Through this study discomforts of critically ill patients were broadly classified into four categories 1. Due to existing illness, 2. Due to ICU interventions, 3. Due to improper nursing care and 4. Due to environmental factors. Results: Out of 120 patients studied, 84 patients (70%) reported some kind of discomfort during their ICU stay. Existing illness was the most common cause of discomfort, 80 patients (66.6%) suffered due to it. ICU interventions was the second most common cause, 71 patients (59.1%) had discomfort due to interventions. Thirty five patients (29.1%) suffered due to improper nursing care and 25 patients (20.8%) suffered due to the environmental factors. In this study, it was observed that sedation reduces all kind of discomforts. conclusion: In this study 70% of patients, who were admitted to ICU due to various illness reported some kind of discomfort. The most common cause of ICU discomforts was existing illness followed by ICU interventions. In this study it was observed that sedation reduces all kind of discomforts. Sedated patients tolerate the endotracheal tube better and they had less environmental and procedure related discomforts. With the present study observation it can be suggested that ICU charts of nurses and doctors can carry a separate column for mentioning discomforts in different duty shifts. However, with the use of appropriate analgesia and sedation discomfort can be reduced.

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 Case series of paediatric adnexal torsion: rare yet urgent entity

2016 ◽  
Vol 6 (1) ◽  
pp. 315 ◽  
Author(s):  
Vineet Mishra ◽  
Shaheen Hokabaj ◽  
Priyankur Roy ◽  
Rohina Aggarwal ◽  
Bhumika Vyas ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Series ◽  
Conservative Surgery ◽  
Paediatric Population ◽  
Ovarian Torsion ◽  
Care Hospital ◽  
Paediatric Age ◽  
High Degree

Ovarian torsion is a true emergency which warrants early diagnosis and timely surgical management to avoid the catastrophic consequences of further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation of disease. This leads to delay in surgical exploration and loss of ovarian function. We encountered 6 cases of ovarian torsion in paediatric age group during a period of 2 years, at a tertiary care hospital in Ahmedabad. After enquiry of the symptoms and a series of investigations, a provisional diagnosis of torsion ovary was made and they were taken up for surgery. Intra-operatively all the patients were found to have non-salvageable ovary and fallopian tube on the affected side, and subsequently they underwent salpingo-oophorectomy. Diagnosis of ovarian torsion requires clinician awareness and a high degree of suspicion. Conservative surgery, in the form of ovarian detorsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.

scholarly journals Increase of Antimicrobial Consumption in a Tertiary Care Hospital during the First Phase of the COVID-19 Pandemic

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 778
Author(s):  
Alexandre Castro-Lopes ◽  
Sofia Correia ◽  
Cátia Leal ◽  
Inês Resende ◽  
Pedro Soares ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Hospital ◽  
Antimicrobial Consumption ◽  
Lengths Of Stay ◽  
Defined Daily Doses ◽  
Before And After ◽  
Amoxicillin Clavulanic Acid ◽  
Admission Type

Background: The COVID-19 pandemic poses novel challenges in antimicrobial consumption metrics and stewardship strategies. COVID-19 patients became the major cause of hospital admission during the first wave of the pandemic, often leading to an antimicrobial prescription upon admission or treatment for superinfections. The aim of this study was to understand how antimicrobial consumption was impacted at the beginning of the pandemic in a tertiary care hospital, a reference center for COVID-19. Materials and Methods: A retrospective before-and-after study was done. Descriptive statistics of discharges, patient-days, and antimicrobial use indicators (defined daily doses (DDD)/100 discharges, DDD/100 patient-days) for various groups were calculated for the first three months of the pandemic (March, April, and May 2020) as a quarterly value, and for each year in 2011–2019, and their annual percentage changes were used to estimate 95% confidence intervals. The indicators were compared to patient type (medical/surgical), type of admission (urgent/elective), and age groups using Spearman’s correlation coefficient. Results: Statistically significant increases occurred in 2020 for total antibacterials, macrolides, cephalosporins, amoxicillin/clavulanic acid, carbapenems, meropenem, and third-generation cephalosporins, while a reduction was seen in cefazolin/cefoxitin. A correlation was found between antibacterial consumption and patient or admission type. In 2020, unlike in pre-pandemic years, there was a different impact in DDD/100 discharges and DDD/100 patient-days due to increased lengths-of-stay and longer antimicrobial therapy. Conclusions: The COVID-19 pandemic led to an increase in antimicrobial consumption with a different impact in DDD/100 discharges and DDD/100 patient-days. This highlights the need to use both indicators simultaneously to better understand the causes of antimicrobial consumption variation and improve the design of effective antimicrobial stewardship interventions.

scholarly journals Prevalence and molecular characterization of human herpes virus 6 and 7 in patients with pityriasis rosea using polymerase chain reaction in a tertiary care hospital, Puducherry

2019 ◽  
Vol 5 (4) ◽  
pp. 728
Author(s):  
Rangaraj Murugaiyan ◽  
Karthikeyan Kaliyaperumal ◽  
Balamurugan Rangasamy
Keyword(s):  
Herpes Virus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Central Research ◽  
Care Hospital ◽  
Human Herpes ◽  
Pityriasis Rosea ◽  
Human Herpes Virus ◽  
Herpès Virus

<p class="abstract"><strong>Background:</strong> Human herpes virus (HHV) 6 and 7 belongs to <em>Betaherpesviridae</em> a sub-family of <em>Herpesviridae</em>. HHV-6 and HHV-7 are double stranded DNA group viruses. The cause of PR and the disease caused by HHV is not well established. The association of HHV 6 and HHV 7 with pityriasis rosea (PR) is under controversy. The HHV DNA is also detected in normal controls which evidence the non- significance of HHV in the pathogenesis of PR.</p><p class="abstract"><strong>Methods:</strong> The study design was planned for 35 consecutive cases of pityriasis rosea of all age groups. This study was carried out at the department of Dermatology and Central Research Lab, at Sri Manakula Vinayagar Medical College and Hospital, a tertiary care hospital in Puducherry. Since there is no universally accepted diagnostic protocol for PR, we have planned to detect HHV-6 and 7 DNA by PCR from the lesions of all clinically diagnosed cases of pityriasis rosea.<strong></strong></p><p class="abstract"><strong>Results:</strong> In contrary to the expected outcome that HHV-6 and HHV-7 positivity would correlate to the possible pathogenesis of the disease, the PCR results of all the 35 samples from clinically suspected PR cases were found to be negative.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that HHV-6 and HHV-7 viruses may not always play a role in the pathogenesis of the disease. Thus PR speculated to have more than one etiology may have agents other than HHV6 and HHV7 involved in the pathogenesis of the disease.</p>

scholarly journals A Clinical Study of Secondary Glaucoma with Special Reference to Its Proportion, Causes and Its Risk Factors in a Tertiary Care Hospital - A Cross Sectional Study

2021 ◽  
Vol 8 (01) ◽  
pp. 23-27
Author(s):  
Partha Chakma ◽  
Debal Kisor Pal ◽  
Amar Kanti Chakma
Keyword(s):  
Risk Factors ◽  
Special Reference ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Secondary Glaucoma ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Cause

BACKGROUND Secondary glaucoma is an anatomically identifiable abnormality which in turn is an underlying cause of the events that lead to aqueous outflow obstruction and rise in the intraocular pressure. This prospective study mainly highlights the secondary glaucoma with special reference to its proportion, causes and its risk factors in a tertiary care hospital. METHODS This study was a cross sectional study. Patients, who attended the Department of Ophthalmology after fulfilling the inclusion and exclusion criteria diagnosed with secondary glaucoma, were included in the study. The study period was from February 2018 to June 2020. A standard form was filled up for each patient documenting parameters and findings of various examinations and was evaluated as per protocol. RESULTS Secondary glaucoma was seen in 0.2 % patients who visited during the study period. Out of 106 patients, males were 50, females were 56, with a male: female ratio of 1:1.1. The most common cause of secondary glaucoma was lens induced glaucoma seen in 44.34 % followed by uveitic glaucoma in 20.8 % cases, traumatic 17.9 %, neovascular 10.4 %, pseudoexfoliation glaucoma 2.8 %, pigmentary glaucoma 1.9 %, silicon oil induced 0.9 %, and uveitis-glaucomahyphema syndrome in 0.9 % cases. Around thirty five percent (34.9 %) cases presented with sudden onset of painful diminution of vision with nausea and vomiting. CONCLUSIONS Secondary glaucoma is still one of the prevalent diseases in this part of country. Lens induced glaucoma is still the most common cause of secondary glaucoma. Hypermature cataract, uveitis, trauma and neovascularisation are the different risk factors. KEYWORDS Secondary Glaucoma, Lens Induced Glaucoma, Phacomorphic Glaucoma, Uveitic Glaucoma

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