scholarly journals Clinical Characteristics and Maternal Outcome of Obstetrics Patients Admitted to the Intensive Care Unit: Cross Sectional Observational Study

Author(s):  
Tulasi Reddy ◽  
K. Rekha Rani ◽  
M. Chandramathi

Background: According to UNICEF India, annually 44,000 women die due to preventable pregnancy related causes in India. Globally, this ratio is 830 maternal deaths daily according to a WHO newsletter from 2018. ICU / HDU facility provides simultaneous expert obstetrics care and critical medical care under one roof. The concept of ICU / HDU was introduced as a bridge between routine obstetric care and ICU / HDU in under to bypass and decrease the ICU / HDU burden. ICU / HDU care is required for women requiring more detailed observation, intervention including basic support for a single failing organ system, extended post-op care and those stepping down from higher levels of care. Awareness regarding ICU / HDU care and its benefits need to be improved. This study aims to study the maternal outcome of women admitted in tertiary care hospital, Karimnagar, Telangana. Methodology: This is cross sectional observational study was conducted in the department of obstetrics and gynaecology at Chalmeda Anand Rao Institute of Medical Sciences and hospital, Karimnagar, Telangana from June 2019 to March 2020 after obtaining clearance from the institutional scientific and ethical committees. In this study total 600 patients were recruited, out of these 150 patients not met the inclusion criteria & 450 women recruited for questionnaire based proforma, were selected for the study calculated by SPSS 20 software. They have been subjected to thorough history taking, general, obstetric examination and assessment of antenatal records & management & their outcome. Results: The mean age group is 25 yrs. Also found most admission in age group between 20 to 30 yr. Most of the cases were belong to low socioeconomic status (99.2%), Occupationally maximum were unskilled worker (98.3%) in present study, Most of the cases were have secondary level of education (91.6%). In this present study 180 were hypertensive disorder of pregnancy, followed by 128 were haemorrhage disorder of pregnancy, 108 were medical disorder of pregnancy & 34 were sepsis. Maternal mortality was 8.7% in this study. Conclusion: Commonest cause of mortality was hypertensive disorder of pregnancy & more than one diagnosis on admission were the other risk factors for ICU / HDU admission. A dedicated ICU / HDU will go a long way in reducing maternal mortality as the responses time from onset of acute severe illness to provision of high quality critical care will be substantially reduced. Keywords: ICU / HDU, Maternal Outcome, Mortality, Critical Care Unit.

Author(s):  
ASHWANI UMMAT ◽  
RANJODH JEET SINGH ◽  
SONIA KOCHHAR

Objective: The objective of the study is to analyze the prescription pattern of drugs for osteoarthritis (OA) in a north Indian medical college collaborated with a tertiary care hospital. Methods: An observational study was conducted on 300 patients diagnosed with OA in the department of orthopedics in collaboration with the department of pharmacology, and thus, prescription was collected as in a cross-sectional manner for 6 months and the same were analyzed in the Department of Orthopedics in tertiary care hospital collaborated with medical college. Results: The average age of patients participating in this present study was 56.46±7.4 years with affected age group of 46-60 years. 60 % of females were affected by osteoarthritis outnumbering male (40 %) patients in this present study. The most commonly involved joint was knee joint (87.33 %) in patients diagnosed with osteoarthritis followed by back (6.67 %) and hip joint (6%). The combination therapy (90 %) outweighed monotherapy (10 %) with preferred route of drug administration as oral route (90 %) followed by topical route (10 %). The average number of drugs prescribed for patients of osteoarthritis was 2.62±0.76. This present study concludes that NSAIDs (45.8%) were prescribed most commonly. However, the drug paracetamol was lesser prescribed and other drugs such as Diclofenac (27.22 %) and acetaminophen (34.44 %) most of all followed by Nimesulide (16.67 %), ibuprofen (13.33 %) and Rofecoxib/valdecoxib (8.33 %) were prescribed. Conclusion: This present study concludes that NSAIDs were most commonly prescribed as p-drugs while paracetamol was undermined prescribed.


2021 ◽  
Vol 7 (2) ◽  
pp. 399-401
Author(s):  
Dhruvi K Champaneria ◽  
Harish R Trivedi

The main objective of the study was to study the pattern of strabismus, determine the type of refractive error and measure the angle of deviation, determine streoacuity by WFDT in 0-18 years of age group. This was a prospective cross-sectional observational study. Total 50 patients were taken. Patients of 0-18 years of age presenting with squint included in study. Patients were evaluated for VA, both distance and near vision without glasses as well as BCVA tested. Anterior segment evaluation using slit lamp, cycloplegic refraction using atropine (0-9 years) or cyclopentolate (10-18 years), fundus examination, PBCT, WFDT test done. In study, total 50 subjects of 0-18 years of age group was taken. In them boys were more than girls. 49(98%) had comitant strabismus and 1(2%) had incomitant strabismus. 32(64%) had esotropia and 18(36%) had exotropia. Among esotropia 11(34.37%) had accommodative esotropia, 13(40.62%) had partially accommodative, 7(21.87%) had non accommodative, 1(3.12%) had restrictive esotropia. Among exotropia 9(50%) had basic exotropia, 6(33.33%) had divergence excess and 3(16.66%) had convergence insufficiency. 14(28%) had amblyopia. 32(64%) had hypermetropia and 18(36%) had Myopia. 33(64%) had central fixation and 12(24%) had eccentric fixation. In binocularity, 6(12%) had ARC, 25(50%) had unilateral suppression, 10(20%) had alternate suppression.Comitant squint was more common than incomitant squint. Among comitant squint, esotropia was more common than exotropia.


2020 ◽  
Vol 2 (2) ◽  
pp. 08-15
Author(s):  
Rahma Triyana ◽  
Salmi Salmi

Malaria is one of the health problems in Indonesia, especially West Sumatra. Determination of the description of Malaria disease in an area is needed to determine the spread and severity of the disease. This study aims to determine the frequency distribution according to age, sex and place of residence, description of the types of Plasmodium causes of Malaria and hematological features in Malaria patients at Siti Rahmah Padang Hospital in 2018. This type of research is a descriptive observational study with an approach or design cross section (cross sectional). The frequency distribution of Malaria sufferers in Siti Rahmah Padang Hospital in 2018 according to the highest age was in the age group 21-30 years as many as 28 cases (36.8%), the highest sex among men was 46 (60.5%) and the highest number of residences was found in Koto Tangah sub-district there were 31 cases (40.8%). The type of Plasmodium found in Malaria cases in Siti Rahmah Padang Hospital in 2018 was P. vivax (73 cases (96.05%)) and P. falciparum (3 cases (3.95%)). The results of laboratory tests on Hb, hematocrit, platelet and leukocyte levels in Malaria positive patients in Siti Rahmah Padang Hospital in 2018 were in the normal range.


2020 ◽  
Vol 2 (2) ◽  
pp. 08-15
Author(s):  
Rahma Triyana Y ◽  
Salmi Salmi

Malaria is one of the health problems in Indonesia, especially West Sumatra. Determination of the description of Malaria disease in an area is needed to determine the spread and severity of the disease. This study aims to determine the frequency distribution according to age, sex and place of residence, description of the types of Plasmodium causes of Malaria and hematological features in Malaria patients at Siti Rahmah Padang Hospital in 2018. This type of research is a descriptive observational study with an approach or design cross section (cross sectional). The frequency distribution of Malaria sufferers in Siti Rahmah Padang Hospital in 2018 according to the highest age was in the age group 21-30 years as many as 28 cases (36.8%), the highest sex among men was 46 (60.5%) and the highest number of residences was found in Koto Tangah sub-district there were 31 cases (40.8%). The type of Plasmodium found in Malaria cases in Siti Rahmah Padang Hospital in 2018 was P. vivax (73 cases (96.05%)) and P. falciparum (3 cases (3.95%)). The results of laboratory tests on Hb, hematocrit, platelet and leukocyte levels in Malaria positive patients in Siti Rahmah Padang Hospital in 2018 were in the normal range.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045550
Author(s):  
Zhigang Zhang ◽  
Guoqiang Wang ◽  
Yuchen Wu ◽  
Jin Guo ◽  
Nannan Ding ◽  
...  

PurposeTo translate and adapt the Chelsea Critical Care Physical Assessment Tool (CPAx) into Chinese version (‘CPAx-Chi’), test the reliability and validity of CPAx-Chi, and verify the cut-off point for the diagnosis of intensive care unit-acquired weakness (ICU-AW).Study designCross-sectional observational study.MethodsForward and back translation, cross-cultural adaptation and pretesting of CPAx into CPAx-Chi were based on the Brislin model. Participants were recruited from the general ICU of five third-grade class-A hospitals in western China. Two hundred critically ill adult patients (median age: 53 years; 64% men) with duration of ICU stay ≥48 hours and Glasgow Coma Scale ≥11 were included in this study. Two researchers simultaneously and independently assessed eligible patients using the Medical Research Council Muscle Score (MRC-Score) and CPAx-Chi.ResultsThe content validity index of items was 0.889. The content validity index of scale was 0.955. Taking the MRC-Score scale as standard, the criterion validity of CPAx-Chi was r=0.758 (p<0.001) for researcher A, and r=0.65 (p<0.001) for researcher B. Cronbach’s α was 0.939. The inter-rater reliability was 0.902 (p<0.001). The area under the receiver operating characteristic curves of CPAx-Chi for diagnosing ICU-AW based on MRC-Score ≤48 were 0.899 (95% CI 0.862 to 1.025) and 0.874 (95% CI 0.824 to 0.925) for researcher B. The best cut-off point for CPAx-Chi for the diagnosis of ICU-AW was 31.5. The sensitivity was 87% and specificity was 77% for researcher A, whereas it was 0.621, 31.5, 75% and 87% for researcher B, respectively. The consistency was high when taking CPAx-Chi ≤31 and MRC-Score ≤48 as the cut-off points for the diagnosis of ICU-AW. Cohen’s kappa=0.845 (p=0.02) in researcher A and 0.839 (p=0.04) for researcher B.ConclusionsCPAx-Chi demonstrated content validity, criterion-related validity and reliability. CPAx-Chi showed the best accuracy in assessment of patients at risk of ICU-AW with good sensitivity and specificity at a recommended cut-off of 31.


2021 ◽  
Vol 8 (29) ◽  
pp. 2601-2608
Author(s):  
Dileep Kumar Allagadda ◽  
Harikrishna Appana ◽  
Ramu Pedada ◽  
Deepika Gurram ◽  
Ditin Joseph

BACKGROUND Abdominal pain is a common disorder in children and adolescents worldwide with prevalence rate ranging from 20 - 25 % in school-going children in India. It is a frustrating concern to the child, parents and the physician. Even though abdominal pain is one of the most common complaints in children, it poses a diagnostic challenge owing to the variety of underlying causes. The purpose of this study was to evaluate the aetiology of abdominal pain associated with significant mesenteric lymphadenopathy in a paediatric population. METHODS This is a hospital based prospective, observational study done in Department of Paediatrics, Malla Reddy Institute of Medical Sciences (MRIMS), Hyderabad. RESULTS Out of the 65 children studied, 30.8 % were of 5 - 8 years age group, 36.9 % were 9 - 12 years age group and 32.3 % were 13 - 15 years age group. In our study, we found 50.8 % were boys and 49.2 % were girls. 20 % of them were having fever, 16.9 % were having cough, 16.9 % were having diarrhoea, 13.8 % were having sore throat, 16.9 % dysuria, and 15.4 % were having constipation. All patients in our study group underwent ultrasound of abdomen. All cases were having significant mesenteric lymphadenopathy (more than 5 mm in short axis with three or more number of lymph nodes). In 53.8 % cases, etiological agent for the mesenteric lymphadenopathy was not proved with our investigations. In the remaining 46.2 % of children, cause of mesenteric lymphadenopathy was proved and 38.5 % were bacterial infections, 6.2 % were viral infections and 1.5 % were parasitic infections. CONCLUSIONS It is important to recognise mesenteric lymphadenitis as a clinical entity in paediatric cases presenting with abdominal pain. They should be evaluated for an etiological agent and if no proven source of infection and etiological agent is found, it can be considered as functional abdominal pain. If we are able to get a proper etiological diagnosis in these cases, we could treat them and we could make huge difference in terms of quality of life. KEYWORDS Abdominal Pain, Mesenteric Lymphadenitis, Ultrasound, Significant Mesenteric Lymphadenopathy


Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.


Author(s):  
Subrata Kumar Das ◽  
Saptadipa Das

<p class="abstract"><strong>Background:</strong> The aim was to evaluate the parameters of metabolic syndrome (MS) in patients of alopecia areata and to investigate the possibility of an existing relationship between MS and alopecia areata (AA).</p><p class="abstract"><strong>Methods:</strong> This cross-sectional observational study included 50 patients with AA who attended OPD of department of dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.<strong></strong></p><p class="abstract"><strong>Results:</strong> This study included 50 patients with AA (33 males and 17 females). In the present study maximum number of patients belonged to the age group 20-30 years with 23 patients, followed by 30-40 years with 17  patients. Most of the study subjects, 17 were college students and number of employees were 15. Out of 50 patients 44  had patch(es) and 2 patient had alopecia totalis. In this study out of 50 patients, 38 had mild AA, 7 had AA and 5 patients had severe AA. No significant derangement of clinical and laboratory parameters of MS observed in patients of AA.</p><p class="abstract"><strong>Conclusions:</strong> In the present study we did not observe any significant derangement of clinical and laboratory parameters of  MS  in patients of alopecia areata.</p>


Author(s):  
Sandhya Mishra ◽  
Deepak Chopra ◽  
Nidhi Jauhari ◽  
Ausaf Ahmad

Background: Dengue virus infection is a growing health problem and is prevalent throughout India. Research focusing on length of hospital stay and its predictors is scarce from India. This is important considering the burden of the disease during epidemics and impact on hospital admissions. Hence the study was conducted with the objectives to find out the factors influencing the length of stay in hospital of dengue patients.Methods: A cross sectional retrospective observational study conducted at a tertiary care hospital from August 2016 to October 2016. Data was retrieved from case sheets at Medical Record Department of 350 lab confirmed adult dengue patients admitted in the hospital.Results: The majority of patients admitted were of economically productive age group of 18-45 years and males indicating the occupational exposure to the vector of dengue. The study found that majority had length of stay of less than a week and as age increases the length of stay also increases (statistically significant). The nil case fatality and lesser number of mean days of symptoms before admission possibly indicate that early arrival of patients to hospital can lead to very low fatality rates. Further research required to find out the other predictors of length of stay.Conclusions: The study concludes that the dengue affects the economically productive age group and more males thereby indicating occupational exposure to the vector. The age of the patient can be used as an indicator to the length of stay in the hospital.


2021 ◽  
pp. 63-65
Author(s):  
Neena Gupta ◽  
Uruj Jahan ◽  
Subhashini Singh

BACKGROUND: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. For reduction of maternal mortality and morbidity Government of India launched National health mission (NHM). Some of the major initiatives under NHM are– ASHA (Accredited Social Health Activist), JSY/JSSK (Janani Suraksha Yojana / Janani Shishu Suraksha Karyakaram), National mobile medical units, National ambulance services. METHODS: A retrospective observational study was performed in department of Obstetrics and Gynaecology, G.S.V.M Medical College, Kanpur, Uttar Pradesh which is a low performing state, during the period of 2018 to 2019. A total of 5134 obstetric patients including 1032 low general condition patients were included over duration of 20 months since January 2018 to august 2019. This observational study collected information regarding number of deliveries in different years in this tertiary care hospital, effect on availability of health facilities and antenatal care to the antenatal women after introduction of JSY, ASHA and ambulance services. CONCLUSIONS: After JSY there is major difference in OPD admission and institutional delivery rate. Ambulance services had major contributory role in reducing maternal mortality and morbidity. There is need to improve performance of ASHA by proper supervision and monitoring.


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