Relationship between Maternal Hemoglobin Concentration to the Newborn Cord Blood Hemoglobin and Serum Concentration

Objective: To determine the mean cord blood hemoglobin and ferritin concentration in newborn of anemic mothers. Study Design: Cross sectional Place and Duration: Gynae & Obs department of Dow University Hospital, a tertiary care hospital in Karachi, Pakistan during the period from January, 2018 to July, 2019. Methodology: A total of 100 anemic pregnant women as per inclusion and exclusion criteria were included in this study. Cord blood sample (5ml) was obtained by sterile needle puncture immediately after cord clamping. 2ml will collected in EDTA bottle for full blood count analysis and 3ml collected in plain bottle for serum ferritin analysis. Final outcome was recorded on approved proforma. Results: The average age of the patients was 29.33±3.23 years. Mean cord blood hemoglobin and ferritin concentration in newborn of anemic mothers was 14.78±1.62 g/dl and 94.10±67.47 u/ml. Conclusion: We found that average hemoglobin of the women recruited in our study was 9.59±0.815 g/dl however we could find no correlation between mean cord blood hemoglobin and ferritin concentration in newborn of anemic mothers. Key Words: Cord blood Hemoglobin, Ferritin, Anemic mothers

Download Full-text

Hematological profile including alkali resistant hemoglobin of neonates at birth using cord blood in relation to gestational age and maternal diseases

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20164535 ◽

2016 ◽

Vol 5 (1) ◽

pp. 131

Author(s):

Debashis Bhattacharya ◽

Sharmistha Chatterjee ◽

Gargi Sen

Keyword(s):

Cord Blood ◽

Cell Count ◽

Gestational Age ◽

White Cell Count ◽

Tertiary Care ◽

Cord Blood Sample ◽

Care Hospital ◽

Cross Sectional ◽

Hematological Profile ◽

Haematological Profile

Background: The importance of complete hemogram along with the hematological indices in the diagnosis of neonatal health cannot be overemphasized. There is a severe paucity of relevant data regarding neonatal hematological profile in relation to gestational age and maternal diseases in this part of the country. With this perspective, the authors intended to do a pilot study to analyse the haematological profile of neonates of different gestational ages and different maternal diseases born in a teriary care hospital in Eastern India.Methods: This is a cross sectional study design based on cord blood sample of newborns and their mothers recruited from those admitted in the gynae and obstetric department in IPGME&R. The umbilical cord blood was collected from the newborn babies and then examined for different haematological parameters. The data obtained was statistically analysed.Results: While there has been a sequential rise of fetal red cell count, hemoglobin and the total white cell count neutrophils with gestational age, the mean corpuscular cell volume decreased. All these values were comprised to varying degrees in maternal diseases except for nucleated rell blood cells which conspicuously increased in neonates of diabetic mothers.Conclusions: In this study, a small attempt was made to assess the haematological profile (including alkali resistant hemoglobin) of the newborns in relation to gestational age and maternal diseases in the population attending a tertiary care hospital in Eastern India.

Download Full-text

MATERNAL SEPSIS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.05.3239 ◽

2019 ◽

Vol 26 (05) ◽

Author(s):

Fehmida Parveen Memon ◽

Majida Khan ◽

Samya Aijaz

Keyword(s):

Maternal Morbidity ◽

Tertiary Care ◽

Morbidity And Mortality ◽

University Hospital ◽

P Value ◽

Care Hospital ◽

Maternal Complications ◽

Cross Sectional ◽

Maternal Morbidity And Mortality ◽

Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

Download Full-text

Patient Attitudes towards Physician Nonverbal Behaviors during Consultancy: Result from a Developing Country

ISRN Family Medicine ◽

10.1155/2014/473654 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Fahad Hanif Khan ◽

Raheela Hanif ◽

Rumina Tabassum ◽

Waris Qidwai ◽

Kashmira Nanji

Keyword(s):

Nonverbal Communication ◽

Tertiary Care ◽

Eye Contact ◽

Cross Sectional Study ◽

University Hospital ◽

Care Hospital ◽

Nonverbal Behaviors ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9±10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.

Download Full-text

Bleeding Disorders among women Presenting with Menorrhagia at Tertiary Care Hospital

10.53350/pjmhs211592851 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2851-2853

Author(s):

Muhammad Sarwar Khan ◽

Kiran Aamir ◽

Aamir Ramzan ◽

Aasma Naz ◽

Khalil Ahmed Memon ◽

...

Keyword(s):

Tertiary Care ◽

Cross Sectional Study ◽

Von Willebrand Disease ◽

University Hospital ◽

Common Finding ◽

Initial Contact ◽

Care Hospital ◽

Bleeding Disorders ◽

Cross Sectional ◽

Early Management

Objective: To study the spectrum of bleeding disorders among women, presenting to the study setting with complaints of menorrhagia. Methodology: This observational cross-sectional study was conducted up on 121 women, during a period of 6 months, who were approached via non-probability, consecutive sampling, presenting to the Dept. of Gyneacology & Pathology – Liaquat University Hospital, Hyderabad with menorrhagia. Data obtained from patient interviews and laboratory investigations were recorded into a self-structured questionnaire after taking written informed consent. The data obtained was analyzed using SPSS v. 21.0. Results: The mean age of the women was 28.13 years (±5.21 SD). Among the underlying hemostatic pathologies, VWD was the most common i.e. 21 (65.6%), followed by other platelet dysfunctions (Glanzman Thrombasthenia (n=5, 15.6%) and Berard Soulier Syndrome i.e. n=3, 9.4%) comprised the second most common finding. A cause of hemostatic pathology among a minority of patients remained unidentified i.e. n=3 (9.4%). Conclusion: Keeping in view of hemostatic defects, the study concludes that VWD is the commonest bleeding disorder among women presenting with menorrhagia. A routine screening of females with menorrhagia on their initial contact with the hospital can save years of suffering and lead to early management and probable recovery. Keywords: Von Willebrand Disease, Hemostatic Dysfunction, Bleeding Disorders, Platelet Dysfunction, Menorrhagia & Bleeding Complaints among Women

Download Full-text

MO1017PSYCHOSOCIAL REPERCUSSIONS AND QUALITY OF LIFE OF CHILDREN UNDERGOING HEMODIALYSIS IN A DEVELOPING COUNTRY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab108.0014 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Salma Naouaoui ◽

Kamal Ahtitich ◽

Meriem Chettati ◽

Wafaa Fadili ◽

Inass Laouad

Keyword(s):

Quality Of Life ◽

Tertiary Care ◽

Life Assessment ◽

University Hospital ◽

Maintenance Hemodialysis ◽

Care Hospital ◽

Cross Sectional ◽

Daily Life Activities ◽

Significant Difference

Abstract Background and Aims Despite major advances in the provision of renal replacement therapy, children and adolescents on dialysis frequently have compromised daily life activities and a worse quality of life compared with healthy peers. While these aspects have been studied extensively in affluent countries, data from developing regions are scant. The aim of our study was assessing the psychosocial repercussions and the quality of life (QoL) of children with end stage renal disease (ESRD) undergoing hemodialysis in a Moroccan tertiary care hospital and comparing them with healthy controls. Methods We performed a cross-sectional investigation, at Mohammed VI university hospital of Marrakesh, using parent/child reports of generic module for QoL assessment: PedsQLTM Inventory version 4 for both cases and controls. Disease-specific module: PedsQLTM ESRD version 3 was used for ESRD cases. Twenty-two children on maintenance hemodialysis and 50 controls were enrolled in our study. Results The mean age of the ESRD cases was 11.6 ± 4.7 years (range 4– 18 years) with female predominance (58%). Controls were age- and sex-matched. A statistically significant difference was observed between ESRD cases and controls regarding all aspects of QoL. The total QOL mean score was 51.2 ± 13.6 and 82.8 ± 11.2 among cases and controls, respectively. All individual QoL domains were significantly worse in ESRD cases. Conclusion Our findings showed that the quality of life of children undergoing hemodialysis may be dramatically affected especially in limited-resources countries. And this raises the need to introduce quality of life assessment as a part of pediatric ESRD management.

Download Full-text

Device associated healthcare associated infections in a pediatric intensive care unit of a Tertiary Care Hospital, Pakistan.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.5241 ◽

2021 ◽

Vol 28 (03) ◽

pp. 338-343

Author(s):

Shah Ali Ahmed ◽

Anwarul Haque ◽

Qalab Abbas ◽

Humaira Jurair ◽

Zohra Qamar ud Din ◽

...

Keyword(s):

Intensive Care ◽

Blood Stream Infection ◽

Tertiary Care ◽

Pediatric Intensive Care ◽

Blood Stream ◽

Central Line ◽

Cross Sectional Study ◽

University Hospital ◽

Care Hospital ◽

Cross Sectional

Objective: To determine the frequency of Ventilator associated Pneumonia (VAP), Central Line Associated Blood Stream Infection (CLABSI) and Catheter Associated Urinary Tract infection (CAUTI) by using standardized criteria established by Center of disease control and prevention. Study Design: Cross-sectional study. Setting: PICU of Aga Khan University Hospital (AKUH). Period: (August 2015 to January 2016). Material & Methods: Data was collected on a pre-coded proforma. Data was entered and analyzed through SPSS. Results: 156 patients were enrolled. 102 (65.4%) were male. Mean age was 57.59 months. Mean length of stay was 5.6 days. Patient and Device days were 546 and 958 respectively. Device utilization ratio was 0.56. Four Device associated infections (DAI) were identified during study period with a DAI Rate of 4.17 per 1000 device days. All DAI were CLABSIs. Enterococcus was the most frequent bacterial isolate. Conclusion: DAI are highly prevalent in low resource countries, especially in intensive care areas including PICUs. In our setup, CLABSI are increasing while VAP and CAUTI are decreasing.

Download Full-text

Cord Blood Antibody Seroprevalance Against Diphtheria, Pertussis, Measles, Mumps and Rubella among Term Healthy Indian Newborns

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.762 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S323-S324 ◽

Cited By ~ 1

Author(s):

Deepak James ◽

Jula Lavanya ◽

Sanjay Verma ◽

Amit Rawat ◽

Venkataseshan S ◽

...

Keyword(s):

Cord Blood ◽

Tertiary Care ◽

Cord Blood Sample ◽

Care Hospital ◽

Vaccine Preventable Diseases ◽

Northern India ◽

Young Infants ◽

Tdap Vaccine ◽

Protective Antibodies ◽

Term Newborns

Abstract Background The resurgence of vaccine preventable diseases in young infants is a matter of concern worldwide. The aim of our study was to determine the seroprevalance of protective antibodies against diphtheria, pertussis, measles, mumps and rubella antigens in cord blood among term Indian newborns, at birth. Methods Apparently healthy term newborns, delivered at a tertiary care hospital in Northern India, over two year period (Apr 15-March 17) were enrolled after taking informed written consent from their parents; and their cord blood sample was collected. Ethical clearance was obtained from Institute Ethics committee, before enrolling subjects. Cord blood samples were tested for antibodies using commercial ELISA kits IMMUNOLAB IgG. Results A total of 160 newborns (M:F = 86:74) were enrolled. In our study, antibodies (IgG) against diphtheria toxin (DT) were > 0.1 IU/mL in 44.4% (71/160), 0.01 to 0.1 IU/mL in 53.1% (85/160) and < 0.01 IU/mL in 2.5% (4/160). None of their mothers received Tdap vaccine in past. Antibodies (IgG) against pertussis toxin (PT) > 40 U/mL were seen in 41.2% (66/160). Out of these 66 children, 23 had titres > 100 U/mL. Total of 58.8% (94/160) children had antibodies < 40 U/mL. Out of these 94 children, 48 had titers < 20 U/mL. Antibodies (IgG) against measles antigen were > 12 IU/mL in 88.8% (142/160). A total of 11.2 (18/160) had titers below 12 IU/mL. Out of these 18 children, 5 had titers < 6 IU/mL. Antibodies (IgG) against mumps antigen were > 12 IU/mL in 83.1% (133/160). A total of 16.9% (27/160) had titers below 12 IU/mL. Out of these 27 children, 12 had titers < 6 IU/mL. Antibodies (IgG) against rubella antigen were > 12 IU/mL in 83.7% (134/160). A total of 16.3% (26/160) had titers below 12 IU/mL. Out of these 26 children, 22 had titers < 6 IU/mL. Conclusion Only 44.4% of studied newborns were fully protected (> 0.1 IU/mL) against diphtheria, because of maternal antibodies. As correlates of protection for pertussis are not yet defined; those having anti-PT titers >100 IU/mL i.e., 14.3% (23/160) were most protected; while those having titers < 20 U/mL i.e., 30% (48/160) were least protected. Out of studied newborns, fully protected (>12 IU/mL) against measles, mumps and rubella were 88.8%, 83.1% and 83.7% respectively. Acknowledgement. PGI Intramural research grant Disclosures All authors: No reported disclosures.

Download Full-text

Clinical Pattern and Frequency of Co-morbidities among Patients Presented with Cholelithiasis’ at Tertiary Care Hospital

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i1431276 ◽

2021 ◽

pp. 57-62

Author(s):

Juwereya Memon ◽

Muhammad Jarwar ◽

Sohail Ahmed Soomro ◽

Abdul Sattar Memon ◽

Riffat Jabeen Memon

Keyword(s):

Diabetes Mellitus ◽

Smoking Status ◽

Gallstone Disease ◽

Tertiary Care ◽

Gall Stone ◽

University Hospital ◽

Care Hospital ◽

Bladder Tissue ◽

Cross Sectional ◽

Clinical Pattern

Background: Gallstone disease (cholelithiasis) remains the commonest medical issue leading to surgical intervention. Causes of the Gall stone has been not properly understood, but it is thought to have several factors. Untreated gall stones can cause the various complications like inflammation of gall bladder, tissue damage, gallbladder tears and infection. Objective: To determine the clinical pattern and frequency of comorbidities among patients presented with cholelithiasis at Isra University Hospital Hyderabad, Pakistan. Materials and methods: This cross-sectional study was conducted at general Surgery department, Isra University Hospital, Hyderabad. All the patients having diagnosis of gall stone disease, age>18 years and either of gender were included in the study. Patients were selected on outpatient department (OPD) basis. Complete clinical examination was done including abdominal ultrasound and required laboratory investigations. Data regarding demographic information including clinical presentational and comorbidities like diabetes, hypertension and obesity was recorded and also smoking status was assessed. All the data was recorded via study proforma and was analyzed by SPSS version 20. Results: A total of 149 patients were studied, their mean age was 49.23+7.33 years. Females were commonest as 57(38.3%) and males were 92(61.7%). As per clinical presentation pain was found to be most common, particularly as epigastrium pain was found in (93.95%) cases, right Hypochondrium pain (73.82%), pain radiation was more towards scapula (50.33%), dyspepsia was noted in (49.66%), nausea was observed in 44 patients, flatulence in 45 patients and vomiting was least common (21.47%). Diabetes mellitus was 76(51.0%), hypertension was 67(45.0%), overweight were 63(42.3%), obese were 25(16.8%), HCV positive cases were 34(22.8%) and HBV positive cases were 09(59.7%). However smokers were 48(32.2%) and 06(4.0%) were alcohol consumers. Diabetes mellitus, hypertension and obesity were significantly more prevalent in females as compared to males (p=<0.05). Smoking habits and alcohol consumption were mostly found in males (p=<0.05). However HCV and HBV infections were statically insignificant according to gender. Conclusion: It was concluded that gallstone is a common problem and most of the patients who were diagnosed with gallstones were females, obese (BMI>27kg/m2), diabetes mellitus and belonged to fourth decade (40 to 50 years) of their life. Commonest clinical presentations were epigastrium pain, right Hypochondrium pain, pain radiation towards scapula and dyspepsia.

Download Full-text

Still Birth classification: Application of Relevant Condition at Death (ReCoDe) classification system in a tertiary care hospital of Pakistan

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.38.1.4470 ◽

2021 ◽

Vol 38 (1) ◽

Author(s):

Urooj Kashif ◽

Shelina Bhamani ◽

Asma Patel ◽

Zaheena Shamsul Islam

Keyword(s):

Classification System ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

University Hospital ◽

Care Hospital ◽

Maternal Condition ◽

Cross Sectional ◽

Still Birth ◽

Live Births ◽

Relevant Condition

Objectives: To determine the cause of stillbirth after application of relevant condition at death (ReCoDe) classification system. Methods: This was a retrospective cross sectional study of 207 women diagnosed with stillbirth after 24 completed weeks of pregnancy at the Aga Khan University Hospital (AKUH), Karachi between 1st January 2015 and 31st December 2019. The primary objective was to find the cause of stillbirth according to the new classification of relevant condition at death (ReCoDe). Results: There were a total of 32413 live births and 207 stillbirths during the study period thus stillbirth rate of 6 per 1000 live births. In this study, 80% of women were in the age group of 20-35 years, 16% had advanced maternal age while 3.8% of women accounted for less than 20 years. Among the maternal factors; 54.5% cases were booked and the remaining were were un-booked cases. Pre-eclampsia was the most common associated maternal condition (14.9%). Fetal cause accounted for 34.7% of stillbirths and the fetal growth restriction (FGR) was the most common; 23.6%. After application of ReCoDe classification, in 81% of stillbirth cases associated condition were found and only 18.8% of cases were categorized unexplained. Conclusion: Application of ReCoDe classification is easy to understand and applicable, especially in low resource settings with associated causes identified in vast majority of cases. doi: https://doi.org/10.12669/pjms.38.1.4470 How to cite this:Kashif U, Bhamani S, Patel A, Shamsul Islam Z. Still Birth classification: Application of Relevant Condition at Death (ReCoDe) classification system in a tertiary care hospital of Pakistan. Pak J Med Sci. 2022;38(1):133-137. doi: https://doi.org/10.12669/pjms.38.1.4470 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text

Surgical audit: A process of self-evaluation for better future.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.05.4208 ◽

2020 ◽

Vol 27 (05) ◽

pp. 1049-1053

Author(s):

Muhammad Kaleem Ullah ◽

Muhammad Usman Hashmi ◽

Mohsin Sarwar ◽

Abdulaleem ◽

Anosh Aslam Khan ◽

...

Keyword(s):

Tertiary Care ◽

Numerical Data ◽

Cross Sectional Study ◽

University Hospital ◽

Mortality Data ◽

Care Hospital ◽

Health Care Planning ◽

Cross Sectional ◽

Local Study ◽

Patient Department

Objectives: To describe the pattern of thoracic surgical diseases at a tertiary care hospital in South-Punjab Pakistan. Study Design: Descriptive, cross-sectional study. Setting: Nishtar Medical University hospital Multan, Pakistan. Period: From 01-01-2018 to 31-12-2018. Material & Methods: All the patients who were admitted through the out-patient department or referred from other units, over the year 2018, were analyzed. Variables under consideration included mode of admission, patient’s diagnosis, a surgical procedure performed, type of anesthesia-induced and the mortality. Data were analyzed using IBM SPSS statistics version 20. Mean and percentages were used for numerical data. Data were presented using descriptive statistics. Results: A total of 634 patients (370 females and 264 males) were admitted during the study period, out of which 566 came through the out-patient department while the remaining were referrals from other wards. In total, 697 surgeries were performed with esophagoscopy and dilation being the most frequent (38.7%), followed by tracheostomy (16.3%). Corrosive intake (49.8%) accounted as the cause for the highest number of admissions followed by empyema thoracis (11.4%). Conclusion: Local study on the topic of Thoracic Surgery audit, in terms of surgeries performed and variation of cases presented has become an absolute necessity for better health care planning of Pakistan. The pattern of thoracic surgical diseases varies considerably in different regions and populations. The evaluation of these disease patterns can help to adopt appropriate preventive measures to reduce the incidence of these diseases. Furthermore, it can significantly improve our health system.

Download Full-text