scholarly journals STRATEGIES FOR ANESTHESIA MANAGEMENT OF CESAREAN DELIVERIES WITH ABNORMAL PLACENTAL PLACEMENT–ANESTHETIST’S PERSPECTIVE

2021 ◽  
Vol 71 (5) ◽  
pp. 1778-81
Author(s):  
Maqsood Ahmad
Keyword(s):  
Observational Study ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
General Surgeon ◽  
Bladder Injury ◽  
Care Hospital ◽  
Elective Cesarean

Objective: To discuss problems faced in the management of emergency and elective cesarean sections with known or unknown abnormal placental placement and their management. Study Design: Retrospective observational study. Place and Duration of Study: Different Hospitals for the last 7 years from 2013 to 2020. Methodology: This retrospective observational study of 120 cases was selected for data collections that underwent anesthesia. Variables under study were age, weight, type of abnormal placenta, fluid, blood/blood products given during surgery, hysterectomy done, general surgeon help required, anesthesia type, and redo of operations. Results: A total of 120 patients were operated having abnormal placentation. The frequency of placenta previa 90 (75%), and accreta was 30 (25%). Primigravida patients were 19 (15.8%) and multigravida patients were 101 (84.1%). hysterectomy was done in 28 (23.3%) patients. Spinal anesthesia was given in 50 (41%) patients while 70 (58.3%) patients have general anesthesia. The spinal anesthesia was later on converted to general anesthesia in 32 (26.6%) patients out of 50 (41%). Only 12 (10%) patients were reopened for uncontrolled bleeding and 4 (3.3%) patients were sent to tertiary care hospital for further management. The general surgeon was called for help in 24 (20%) of patients and bladder injury occurred in 25 (20.8%) patients. No mortality was found during this period. Conclusion: Abnormal placental placement is a threat to mother life as well fetus and team of dedicated doctor is required to deal with this emergency. Use of inotropes can help to save the precious lives.

scholarly journals ECG CHANGES IN PATIENTS WITH COVID-19 – A RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN CHENNAI

2021 ◽  
pp. 5-7
Author(s):  
A .Shaik Sulaiman Meeran ◽  
T. Balaji ◽  
P. Raja ◽  
Kiran Chandramohan
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Virus Disease ◽  
Tertiary Care ◽  
P Wave ◽  
Retrospective Observational Study ◽  
Care Hospital ◽  
Icu Admission ◽  
Corona Virus ◽  
Increased Risk

Background:A global outbreak of corona virus disease, caused by severe respiratory corona virus 2, has emerged since December 2019. However electrocardiographic manifestations of patients with COVID-19 have not been fully described. We aim to investigate ECG characteristics in COVID-19 patients and risk factors of ICU admission Methods:This retrospective observational study included the patients with COVID-19 at the Government Kilpauk Medical College, Chennai between June 1st and 31st, 2020. Demographic, clinical and ECG characteristics were collected and comparison were made between ICU and non ICU admission groups. Logistic regression was used to identify risk factors of ICU admission Results:Among the 159 patients included ST-T abnormalities were the most common ECG feature followed by arrhythmias. Compared with non ICU group, the ICU group showed higher heart rate and P wave duration and was more frequently associated with CVD, ST-T abnormalities, arrythmias, QTc prolongation and pathological Q waves. ST-T abnormalities and history of CVD were associated with increased risk of ICU admission Conclusion:COVID-19 is frequently related to cardiovascular manifestations including ECG abnormalities and cardiovascular comorbidities. ST-T abnormalities and CVD at admission were associated with increased odds of ICU admission

scholarly journals Indications and Complications of Obstetric Hysterectomy in a Tertiary Care Hospital of Lahore

2018 ◽  
Vol 24 (S) ◽  
pp. 831-835
Author(s):  
Shamila Ijaz Munir ◽  
Riffat Iqbal ◽  
Shamsa Humayun ◽  
Saima Chaudhary
Keyword(s):  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Haemorrhagic Shock ◽  
Bladder Injury ◽  
Care Hospital ◽  
Maternal Complications ◽  
Ureteric Injury ◽  
Normal Delivery ◽  
Risk Patients

OBJECTIVES: To find out the frequency of obstetric hysterectomy, its indications and associated maternal complications in a tertiary care hospital of Lahore, Pakistan. METHODOLOGY: This is a retrospective observational descriptive study. It was done in Department of Obstetrics and Gynaecology of a Tertiary Care Hospital, Lahore from Feb 2015 to Jan 2016. All the records of patients, who had undergone hysterectomy, within 24 hours of normal delivery or caesarean section, were reviewed. The details of age, parity, booking status, indication and Complications of operation were recorded on a predesigned proforma. RESULTS: The total deliveries during the period were 5, 754. Obstetric hysterectomy was performed in 26 patients. This gives frequency of the emergency obstetric hysterectomy in our unit to be 4.5/1000 births. The major indication was previous caesarean sections with placenta previa and/or accreta in 17 cases (65.38%), followed by massive postpartum haemorrhage due to uterineatony in 4 cases (15.38%), uterine rupture in 3(11.5%) and abruption placenta in 2 (7.6%). Most common complication was haemorrhagic shock seen in 14 patients. There were 5 cases of bladder injury, 2 Ureteric injury and 2 vault hematomas. Maternal deaths occurred in 3 cases. CONCLUSION: Emergency obstetric hysterectomy is increasing with increased frequency of caesarean sections and placenta previa and accreta. Antenatal booking of high risk patients, timely referral to tertiary care hospital with good surgical expertise and ICU care can reduce morbidity and mortality in such cases.

scholarly journals Intentional or unintentional drug poisoning in elderly people: retrospective observational study in a tertiary care hospital in Japan

2019 ◽  
Vol 6 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Takeshi Haoka ◽  
Nobuo Sakata ◽  
Hiroyuki Okamoto ◽  
Akiko Oshiro ◽  
Takafumi Shimizu ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly People ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
Care Hospital ◽  
Drug Poisoning
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