scholarly journals Spectrum of Neonatal Surgical Problems in the Newborn: Incidence, Clinical Course, Immediate Outcome, Follow up Study in a Tertiary Care NICU

2019 ◽  
pp. 1-9
Author(s):  
K. G. Sachin ◽  
K. R. Sachin ◽  
H. Ramesh ◽  
Guru Prasad ◽  
Harsha Bullapur
Keyword(s):  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Population Control ◽  
Tertiary Care ◽  
Relevant Information ◽  
The United States ◽  
Physical Structure ◽  
Neonatal Deaths ◽  
Medical College

Background: A congenital anomaly may be defined in terms of physical structure as a malformation, an abnormality of physical structure or form usually found at birth or during the first few weeks of life. Congenital anomalies affect approximately 1 in 33 infants and result in approximately 3.2 million birth defect-related disabilities every year. Congenital anomalies or birth defects are relatively common, affecting 3% to 5% of live births in the United States (US) and 2.1% in Europe. Congenital anomalies account for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. Objectives: To provide an insight on the burden and types of surgical problems encountered in our NICU of Bapuji Child Health Institute & Research Center, JJM Medical College, Davangere, Karnataka, India and to study the incidence, clinical profile and outcome of surgical condition. Methodology: A total of 3820 babies were examined over a period of 2 years. The relevant information was documented on a semi-structured proforma and analysed. Results: Overall incidence of congenital malformations at birth was 24.8 per 1000 births. The GIT system (51.58%) was most commonly involved followed by respiratory system (26.32%). The incidence of congenital malformation was more in male babies than female babies. Increased frequency was seen in babies born to mothers between 26–30 years & primigravida. The factors which significantly increased the rate of congenital malformations were consanguinity in parents & bad obstetric history. Out of 95 cases, 72% got discharged normally, 18% died in NICU and 10% got discharged against medical advise. Conclusion: With emphasis on “small family” norms and population control it is necessary to identify malformations so that interventional programmes can be planned. Systematic clinical examination of newborns for early detection of anomalies that may warrant medical or surgical intervention. Accurate antenatal anomaly scan need to be done to identify major malformations and terminate the pregnancy.

scholarly journals Incidence of congenital anomalies in newborn in tertiary care hospital

2019 ◽  
Vol 6 (4) ◽  
pp. 1603
Author(s):  
V. Narmadha ◽  
M. Nirmala
Keyword(s):  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Paternal Age ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Changing Trend ◽  
One Year

Background: Just about three decades ago (1976) congenital malformations comprised 8% of perinatal deaths, from available data and ranked fifth as a cause of perinatal mortality. But the trend is rapidly changing over the years. perinatal death was due to congenital malformation, is the second commonest cause. This changing trend over years warns us that with the control of nutritional and infectious diseases, congenital malformations will come to the forefront as it is in India. To find out the incidence of congenital anomalies in stillbirth. And the probable etiology of congenital anomalies.Methods: The study was conducted at Government Mohan Kumaramangalam Medical College Hospital, Salem in the year 2017 August- September 2018. Totally 5000 babies born of consecutive deliveries were taken for the study, over the period of one year. All mothers were interrogated within 48 Hours of delivery as per the proforma prepared, which contains the following particulars like, maternal and paternal age, consanguinity, detailed antenatal history with reference to exposure to teratogens, especially during 1st Trimester.Results: Of the five thousand consecutive deliveries 48 deliveries were multiple delivers and a number of stillbirths were 108. The incidence of congenital anomalies was 30.4 per 1000 live birth (152 cases). Major malformations were present in 20.8 per 1000 (104 cases) while minor malformations were 9.6 per 1000 (48 cases).Conclusions: Incidence of malformation were higher in preterm babies 6.31%. Incidence of malformations were higher in male babies, especially genitourinary system anomalies. Antenatal events in the 1st trimester like fever, drug intake could be implicated in the etiology of malformations especially neural tube defects in our study.

scholarly journals Spectrum of congenital anomalies of neonates in a tertiary care hospital in Southern India

2018 ◽  
Vol 5 (2) ◽  
pp. 314
Author(s):  
Ananya S. L. Tenali ◽  
Santosh K. Kamalakannan ◽  
Kumutha K. Jayaraman
Keyword(s):  
Congenital Anomalies ◽  
Tertiary Care ◽  
Care Hospital ◽  
Patient Counseling ◽  
Frequency Pattern ◽  
Neonatal Deaths ◽  
Minor Anomalies ◽  
Difficult Challenge ◽  
Cns Anomalies

Background: Congenital anomalies contribute upto 11% of neonatal deaths globally. Neonates with multiple congenital malformations present a very difficult challenge to the treating physicians. This study was done to know the frequency, pattern of congenital anomalies and various presentations, which may help to develop strategies for patient counseling and management in our setting.Methods: Retrospective hospital based observational study from the period of June 2015 to June 2017. Neonates born in our hospital during the study period with documented congenital anomalies were included in the study and the data was classified as per European Surveillance of Congenital Anomalies and further analysed.Results: Total number of neonates with documented congenital anomalies was 40, of which 6 neonates (15%) had multiple anomalies. The anomalies in the study were divided into major and minor anomaly groups. 70% of the anomalies were classified as major anomalies while 30% were classified as minor anomalies. Multiparity and GDM were found to be major risk factors in the mother. Major anomalies identified involved the Musculoskeletal system (21.6%) and cardiovascular system (20%). Minor anomalies included skin disorders (27.7%) followed by Musculoskeletal (16.6%) and genitourinary system (16.6%). Of the 40 anomalous babies five babies expired soon after birthConclusions: Antenatal screening is an effective tool to detect Musculoskeletal and CNS anomalies. CVS anomalies may be missed by routine anomaly scan. Early intervention and effective follow up have shown that good outcomes are possible even in while managing some of the major anomalies. 

scholarly journals A study of gross congenital malformation at birth

2019 ◽  
Vol 6 (3) ◽  
pp. 1019
Author(s):  
Pooja R. Gandhi ◽  
Hetal D. Vora ◽  
Halak J. Vasavada ◽  
Mehul T. Patelia ◽  
Pragneshkumar L. Popatiya ◽  
...  
Keyword(s):  
Congenital Malformation ◽  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Tertiary Care ◽  
Folic Acid Supplementation ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Familial Patterns

Background: A congenital anomaly is a structural anomaly of any type that is present at birth. Congenital anomalies may be induced by genetic or environmental factors. Most congenital anomalies, however, show the familial patterns expected of multi-factorial inheritance. The aims and objective of this study were to study the incidence of visible congenital malformations at birth, to study risk factors, to find associated internal malformations.Methods: It is a retrospective cross-sectional study carried out in a tertiary care hospital affiliated to a medical college. The Inclusion criteria include all new-borns delivered in the hospital with visible congenital malformations examined within 48 hours of birth. Extramural babies were included if they had presented within 48 hours after birth. The Exclusion criteria include still births were excluded from the study.Results: Percentage of congenital malformation was 1.32%. Most common systems involved were musculoskeletal system (46.34%) followed by genitourinary system (21.34%) and gastrointestinal system (14.02%).Conclusions: All Babies with gross congenital malformation should be screened for internal malformation. The incidence of CNS malformation has reduced than observed in previous studies which suggest awareness about antenatal folic acid supplementation. Other than CNS anomalies, other system anomalies were not diagnosed antenatally despite antenatal ultrasound being done in maximum number of mothers, which suggest use of 3D or 4D scan antenatally.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

scholarly journals A retrospective study on management of bell\'s palsy in a tertiary care hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 173-176
Author(s):  
P.K Purushothaman ◽  
Dhanyan Harshidan ◽  
Priyangha Elangovan
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Care Hospital ◽  
Bell's Palsy ◽  
College Hospital ◽  
Medical College ◽  
Therapeutic Measures

Bell's palsy is the most common facial nerve disorder. The clinical symptoms of Bell's palsy include facial muscle paralysis, difficulty in eating, drinking and talking. Bell's palsy management is still controversial. Many patients recover spontaneously; some require medicines like corticosteroids, antiviral drugs and other managements.To study the effectiveness of Bell's palsy management that has been followed in our institution.This analysis had carried out from June 2016 to June 2019at SRM Medical College Hospital and Research Institute, Chennai. Total of 30 patients with Bell's palsy who had admitted in the Department of Otorhinolaryngology had enrolled in this study. All the patients underwent thorough clinical examination and laboratory investigation, and the results were statistically analyzed and discussed.Out of 30 patients, 16(53%) patients were males, and 14(47%) patients were females. 53.3% of patients had onset of symptoms after 48 hours. There was a statistical significant improvement in House-Brackman scale on 6 months follow-up.The therapeutic measures for Bell's palsy if initiated within 72 hours of onset aids in bringing better outcome and improves the quality of life in patients.

scholarly journals Study of pattern of congenital anomalies at tertiary center in Maharashtra, India

2018 ◽  
Vol 7 (7) ◽  
pp. 2802
Author(s):  
B. B. Yadav ◽  
S. B. Yadav ◽  
P. K. Damase
Keyword(s):  
Congenital Anomalies ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Second Trimester ◽  
Community Based ◽  
Common Pattern ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Tertiary Center

Background: To highlight common pattern of congenital malformation seen at hospital population of tertiary care center in Maharashtra.Methods: The study was a descriptive prospective study and conducted in the department of obstetrics and gynaecology of government medical college Latur, Maharashtra for a period of six months. Study includes all womens coming for 2nd trimester MTP due to congenital anomalies in foetus and women’s admitted in labour having anomalous foetus. Details of maternal age, parity, type of anomaly present and sex of fetus were noted.Results: Total babies born in the study period were 3482 (including the second trimester abortions). Total babies with congenital abnormality were 75, making the prevalence 2.15%. 10 cases (13.33) had multiple anomalies involving more than one system. The predominant system involved was central nervous system 40 (53.33%) followed by gastrointestinal system 15 (20%). In this study male babies affected more than females.Conclusions: Prevalence of the congenital anomalies will be definitely higher at tertiary care center and to know prevalence in community, more community based studies are required. Increased awareness about preventable risk factors may help in reducing the incidence of congenital anomalies.

scholarly journals Penetrating neck injuries with laryngeal framework involvement: in a tertiary care centre

2019 ◽  
Vol 5 (5) ◽  
pp. 1379
Author(s):  
Chozhan Periasamy ◽  
Malarvizhi Ravisankar ◽  
Mathumithaa Subburayalu
Keyword(s):  
Vocal Fold ◽  
Treatment Plan ◽  
Tertiary Care ◽  
Young Male ◽  
Neck Injuries ◽  
Tertiary Care Centre ◽  
Male Population ◽  
Medical College ◽  
Laryngeal Injury

<p class="abstract"><strong>Background:</strong> Penetrating neck injuries are very common as a mode of homicidal and suicidal injuries. Not many of them are deep enough to affect the laryngeal framework.</p><p><strong>Methods:</strong> Prospective study in the Department of ENT Stanley Medical College, Chennai. The study period was from January 2018 to December 2018. Follow up of 3 months was done.</p><p class="abstract"><strong>Results:</strong> Penetrating neck injuries treated on emergency care with tracheostomy and wound exploration and repair. It was found to be more common in young male population.</p><p><strong>Conclusions:</strong> Laryngeal framework involvement necessitates tracheostomy during wound exploration. On table laryngeal injury repair improves prognosis and early post-operative vocal fold assessment helps frame a treatment plan designed specifically for the patient.</p>

scholarly journals A comparative study between coblation adenoidectomy and conventional adenoidectomy

2018 ◽  
Vol 4 (3) ◽  
pp. 721
Author(s):  
V. Saravana Selvan ◽  
Muthamil Silambu ◽  
D. Vinodh Kumaran
Keyword(s):  
Comparative Study ◽  
Pain Score ◽  
Tertiary Care ◽  
Conventional Technique ◽  
School Absenteeism ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Intraoperative Bleeding ◽  
Medical College

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the advantages and results between coblation adenoidectomy and conventional adenoidectomy by curettage.</p><p class="abstract"><strong>Methods:</strong> The study was<strong> </strong>conducted in Stanley medical college, Chennai (a tertiary care centre) from June 2013 to June 2016. Fifty patients were studied who underwent adenoidectomy. Twenty five patients underwent conventional adenoidectomy by curettage and rest by nasal endoscopy assisted coblation adenoidectomy. Following outcomes were evaluated: pain score on first day, days reporting pain, analgesic days, school absenteeism, endoscopic adenoid grading and intraoperative bleeding.  </p><p class="abstract"><strong>Results:</strong> Patients who underwent coblation adenoidectomy showed better results during follow up with lesser complications.</p><p class="abstract"><strong>Conclusions:</strong> Coblation adenoidectomy is a better technique when compared to conventional technique of curettage.</p>

scholarly journals Prospective study of radiation related adverse events and its management in cancer patient at tertiary care teaching hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 451
Author(s):  
Rohit . ◽  
Devesh Kumar Joshi ◽  
Raja Paramjeet Singh Banipal
Keyword(s):  
Radiation Therapy ◽  
Adverse Events ◽  
Prospective Observational Study ◽  
Background Radiation ◽  
Tertiary Care ◽  
Clinical Results ◽  
Medical College ◽  
Burden Of Treatment ◽  
Patient Burden

Background: Radiation therapy is associated with certain adverse events which may cause significant discomfort to patient and may affect patient’s life. The objective of the study was to assess radiation related adverse events in the patients who are on radiation therapy and to prevent and manage these adverse events.Methods: A prospective observational study was conducted on 193 patients receiving radiotherapy in Oncology Department at Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. One fraction (2 Gray) dose had been given to patients daily for five days in a week and monitor. The collected data was analyzed by applying IBM SPSS v21.Results: The clinical results observed in 193 consecutive patients with follow-up of 7 weeks and graded according to RTOG Acute Radiation Morbidity Scoring Criteria. Majority of events were reported in age group of 41-60 years followed by 61-80 years, 20-40 years. Epidermal, mucosal, Genitourinary and Lower G.I. reactions are graded. The reactions managed by providing symptomatic treatment.Conclusions: Radiation related adverse events have been found frequently in patients with radiotherapy and chemo-radiotherapy both. As the number of doses increase with time the grade of reactions also increases. Appropriate follow-up and management of these events reduces patient burden of treatment.

scholarly journals Mortality profile of neonatal deaths and deaths due to neonatal sepsis in a tertiary care center in southern India: a retrospective study

2018 ◽  
Vol 5 (4) ◽  
pp. 1583 ◽  
Author(s):  
N. Muthukumaran
Keyword(s):  
Neonatal Sepsis ◽  
Congenital Malformations ◽  
Case Fatality Rate ◽  
Distress Syndrome ◽  
Tertiary Care ◽  
Case Fatality ◽  
Meconium Aspiration Syndrome ◽  
Coagulase Negative Staphylococcus ◽  
Fatality Rate ◽  
Neonatal Deaths

Background: The Neonatal mortality rate is an important indicator for newborn care and directly reflects prenatal, intranatal, and postnatal care. Objective: Primary objective was to analyse the neonatal mortality profile, incidence of neonatal sepsis among neonatal deaths and the pattern of antimicrobial resistance.Methods: This was a retrospective descriptive study done in a tertiary care regional center. All neonatal deaths from January 2017 to December 2017 were reviewed and primary causes of deaths, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed.Results: Common causes of neonatal deaths were respiratory distress syndrome (27.4%), asphyxia (23.3%), sepsis (20.1%), congenital malformations, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (96.8%), followed by respiratory distress syndrome (35.9%), asphyxia (33%), meconium aspiration syndrome (29.4%), congenital malformations (28.8%), and sepsis (22.6%). In present study incidence of neonatal sepsis among total neonatal deaths was about 20.1%. Coagulase negative staphylococcus(CONS) (38.6%) and Klebsiella pneumoniae (32.7%) were the predominant organisms isolated. Highest case fatality rate was associated with Pseudomonas sepsis (80%), K. pneumoniae sepsis (64.8%), followed by Escherichia coli sepsis (57%) and non fermenting Gram negative bacilli (55.6%).Conclusions: Sepsis still remains one of the leading cause of death in developing countries. Coagulase negative staphylococcus (CONS) and Klebsiella pneumoniae were the most common organism. 15 % enterococci and 9.7 % of CONS were resistant to vancomycin. 24 % of K. pneumoniae and 16.6% non fermenting Gram negative bacilli were resistant to amikacin. Multidrug resistance is an emerging problem.

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