scholarly journals Short Term Outcomes of Early Term Neonates in a Tertiary Care Centre: A Descriptive Study

2021 ◽  
pp. 916-920
Author(s):  
P. Ragasudhin ◽  
Harish Sudarsanan ◽  
J. Kumutha
Keyword(s):  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Tertiary Care ◽  
Short Term ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Term Neonates ◽  
Early Term ◽  
Increased Risk

Introduction: The number of babies delivered between 37 weeks to 38 weeks and 6 days has been on the rise with increase in lower segment caesarian section (LSCS). These early term neonates have increased risk of developing respiratory distress syndrome, neonatal hyperbilirubinemia, transient tachypnoea, prolonged hospital stays, hypothermia, and feeding difficulty, when compared to a term neonate. An audit of early term neonatal short-term outcomes was undertaken at our institute. Methodology: A retrospective descriptive cross- sectional study was carried out between July 2020 and December 2020 at a private medical college Neonatal Intensive Care Unit. Neonates with a gestation age of 37 weeks and 0 days to 38 weeks and 6 days born were included. Results: A total of 137 early term delivery data were obtained. Hypothyroidism (23%) and gestational diabetes (23%) were found to be the most common associated antenatal problems. The most common morbidity out of 137 early term neonates was neonatal jaundice 91(66.4%) followed by respiratory distress which affected 38 (28%) neonates. Conclusion: This study establishes the high incidence of neonatal jaundice and respiratory morbidities in early term neonates. Hence it is better to avoid elective LSCS before 39 weeks of gestation provided there are no medical indications for the same.

scholarly journals Estimation of Anti-HBs Titer in Health Care Professionals of a Tertiary Care Centre of Southern Assam

2021 ◽  
Vol 8 (8) ◽  
pp. 510-515
Author(s):  
Debadatta Dhar Chanda ◽  
Atanu Chakravarty ◽  
Barnamoy Bhattacharjee
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Protective Level ◽  
Serum Samples ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Chewing Tobacco ◽  
Increased Risk

Background- Due to occupational exposure to blood, body fluids and sharps, the health care professionals are at increased risk of contracting the Hepatitis B virus infection than general population. To combat this, all the health care professionals must be immunized with protective level of anti-HBs but anti-HBs titer gradually wanes with passage of time and may be influenced by gender, smoking or chewing tobacco, diabetes mellitus etc. This study was thus carried out to find the percentage of health care professionals with protective titer of anti-HBs and find the association (if any) of low anti-HBs titer and factors like gender, smoking, diabetes mellitus and time elapsed post vaccination. Method- This cross-sectional study has been carried out with proper ethical clearance from May2018- September2019 in Serology section of VRDL under Department of Microbiology in a Medical College of Southern Assam on serum samples collected from 150 health care professionals vaccinated with 3 doses of recombinant HBsAg vaccine atleast 5years back. Anti-HBs IgG concentration was measured by conventional ELISA in multistandard mode. Result- Out of 150 participants,95 were males and 55 were females.27 participants smoked/chewed tobacco,8 had diabetes mellitus. Booster dose was received by 23. Protective level of anti-HBs IgG (>10 IU/ml) was found in 66% (98/150) of HCP only. Low anti-HBs titer has been found to be significantly associated with Diabetes mellitus (p–0.03) and passage of more than 10 years post primary vaccination(p-0.005) but no significant association has been found with gender, smoking and history of blood transfusion. Conclusion- HBsAg vaccine doesn’t impart everlasting protection. So, all HCP, especially those with co-morbidities should get their anti-HBs titer estimated after vaccination to check out for adequate seroconversion and attainment of protective titer. If found inadequate, they should go for repeat vaccination /booster doses. Keywords: Healthcare professionals, Vaccinated, Anti HBs IgG, Assam,

scholarly journals A cross sectional observational study to evaluate the maternal and fetal outcome in postdated pregnancies

2020 ◽  
Vol 10 (1) ◽  
pp. 159
Author(s):  
Ritika Narayan ◽  
Sheela S. R.
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Significant Risk ◽  
Fetal Distress ◽  
Perinatal Complications ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Increased Risk

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.

scholarly journals Prevalence of Metabolic Syndrome in Patients with Subclinical and Overt Hypothyroidism Visiting Tertiary Care Centre of Western Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 33-37
Author(s):  
Amit Chandra Jha ◽  
Kedar Nath Koirala ◽  
Archana Jayan ◽  
Narayan Gautam ◽  
Raju Kumar Dubey ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Colorimetric Method ◽  
Hormone Deficiency ◽  
Overt Hypothyroidism ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Increased Risk

INTRODUCTION: Hypothyroidism is a syndrome resulting from thyroid hormone deficiency. Metabolic syndrome (MetS) is a cluster of metabolic abnormalities is associated with increased risk for atherosclerotic cardiovascular disease (CVS) and type 2 diabetes mellitus. Thyroid hormones are major regulatory hormones that control the rate of metabolic function; thus, alteration in the levels of these hormones may be associated with MetS. The objective of our study was to find out the prevalence of MetS in subclinical and overt hypothyroidism. MATERIAL AND METHODS: A hospital-based cross sectional study was conducted at Universal College of Medical Sciences Teaching Hospital (UCMS-TH) Bhairahawa from March to September 2019. A total of 222 hypothyroid patients were enrolled in this study. MetS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III; 2005) revision criteria. The anthropometric indices were recorded. fT3, fT4  and TSH were measured by chemiluminescence immunoassay (CLIA) method and other biochemical parameters were estimated by colorimetric method. Data were analyzed by using SPSS 16.0. RESULTS: Patients were aged between 10 and 60 years, with a mean age of 38.89 years. The prevalence of MetS was 44.1% of which 80.6% were females. Furthermore, the prevalence of MetS was found to be 43.7% in subclinical hypothyroidism and 46.6% in overt hypothyroidism. CONCLUSION: The prevalence of MetS is high in both overt and subclinical hypothyroidism. Screening for MetS in patients with hypothyroidism can reduce the risk for CVD, as well as the mortality rate and mortality associated with it.

scholarly journals Morbidity profile of infants of mothers with gestational diabetes admitted to a tertiary care centre

2017 ◽  
Vol 4 (3) ◽  
pp. 960
Author(s):  
Devi Meenakshi K. ◽  
Narayana Babu R. ◽  
Srinivasan Padmanaban
Keyword(s):  
Gestational Diabetes ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Tertiary Care Centre ◽  
Insulin Group ◽  
Increased Risk ◽  
Meal Plan

Background: Infants born to mothers with gestational diabetes are at increased risk of neonatal morbidities like birth trauma, hyperbilirubinemia, hypoglycemia, birth asphyxia etc., Maternal glycemic control has been one of the parameters that determines the occurrence of these problems.Methods: A retrospective study done by analysing the case records of babies born to mothers with gestational diabetes and admitted to the NICU of Govt Kilpauk Medical college from January 2015 to December 2015. The morbidity profile of infants born to mothers with gestational diabetes was analysed and comparison was made between the two groups namely mothers who were managed by meal plan and those who were managed by insulin.Results: About 198 babies were analysed majority were delivered by caesarean section (83%). Only 2 babies (1%) weighed more than 4000gms. The commonest morbidity observed was hyperbilirubinemia (24.2%) which was 27.7% in the insulin group as against 19% in the group on meal plan. The next common morbidity was sepsis (15.2%). This was also common in insulin group 18.5% as against 10.1% in the meal group. Others were hypoglycemia (4%), congenital heart disease (2.5 %) and respiratory distress syndrome (1.5 %).Conclusions: Babies born to mothers with gestational diabetes were found to have morbidities like hyperbilirubinemia and sepsis. Less commonly found morbidities were hypoglycemia, birth asphyxia, respiratory distress syndrome etc., Though the morbidities were more common among insulin group as compared to the group on meal plan this difference was not statistically significant. 

scholarly journals Prevalence and outcome of asymptomatic bacteriuria in early pregnancy

2016 ◽  
Vol 6 (1) ◽  
pp. 223 ◽  
Author(s):  
Sreekumary Radha ◽  
Bindu Nambisan ◽  
Nisha Kizhekkepurakkal Prabhakaran ◽  
Shahida Jamal
Keyword(s):  
Urinary Tract ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Primary Objective ◽  
Premature Delivery ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Increased Risk ◽  
Adverse Pregnancy

Background: Bacteriuria is a major risk factor for developing symptomatic urinary tract infection which is associated with significant maternal and fetal risks. Various studies have put a prevalence of asymptomatic bacteriuria between 2-10% in pregnancy. Maternal and fetal complications like gestational hypertension, anaemia, premature delivery, IUGR, and low birth weight are commonly associated with pyelonephritis which occurs as a result of undiagnosed or inadequately treated infections of the urinary tract. The primary objective was to find out the prevalence of asymptomatic bacteriuria in pregnancies less than 28 weeks gestation in our hospital and to study the various adverse pregnancy outcomes in the study group.Methods: This was a cross sectional study done over a period of 12 months at this tertiary care centre in Government sector in Trivandrum, Kerala. A sample size was calculated statistically and 400 women with gestational age less than 28 weeks attending the outpatient department were included in this study. A structured proforma, urine microscopy and urine culture and sensitivity were the study tools.Results: Prevalence of asymptomatic bacteriuria in our study population was 8.25%. Commonest pathogen isolated was E.coli in 57.14% cases. Maternal morbidity was higher in women with asymptomatic bacteriuria (24.2%) than those without (12.5%). Fetal morbidity in women with asymptomatic bacteriuria was 24% whereas it was 12.5% in those without it. Preterm labour, preeclampsia and prematurity were the common morbidities noted.Conclusions: Since pregnant women with asymptomatic bacteriuria were at an increased risk of adverse maternal and fetal outcome, routine screening for asymptomatic bacteriuria preferably in the first trimester is highly recommended.

scholarly journals Maternal and perinatal outcome of teenage pregnancy in a tertiary care centre

2018 ◽  
Vol 13 (1) ◽  
pp. 26-29
Author(s):  
Anjali Subedi ◽  
Junu Shrestha ◽  
Aashika Shrestha ◽  
Sangeeta Gurung
Keyword(s):  
Cesarean Section ◽  
Teenage Pregnancy ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Normal Vaginal Delivery ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Increased Risk ◽  
Nicu Admission

Aims: To evaluate the maternal and perinatal outcome in adolescent pregnancy,Method: This was a cross-sectional study conducted in Department of Obstetrics and Gynecology, Manipal Teaching Hospital, Pokhara from October 2017 to March 2018 for duration of 6 months.Results: There were total 82 cases of teenage pregnancy in the study duration with incidence of  6% among total deliveries. Majority of cases were of age 19 and were primigravida. Fifty five percent of the cases had normal vaginal delivery and cesarean section accounted for 39% of cases. The major indication for cesarean section was meconium stained liquor (52%) followed by oligohydraminos (15%) and cephalopelvic disproportion (11%). The maternal complication accounted for 59% of total cases. Among them, anaemia was highly prevalent comprising 11% of cases followed by PPROM (9.8%) and hypertensive disorders in pregnancy (8.5%). In perinatal outcome, the incidence of preterm birth was 15.9% and low birth weight was 13.4%. The rate of NICU admission was 2.4% and there was one case of still birth.Conclusion: The study showed that teenage pregnancy is at increased risk of adverse maternal and perinatal outcome. So if we lay an effort for reducing the incidence of teenage pregnancy, we can bring in positive changes in the indicators of maternal and perinatal morbidities.

scholarly journals Prevalence of Diabetes and Dyslipidemia in Hypertensive Young Adults in a Tertiary Care Centre in Nepal, a Cross Sectional Study

2020 ◽  
Vol 42 (2) ◽  
pp. 21-25
Author(s):  
Kamal Sharma Lamsal ◽  
Keshab R Neupane ◽  
Niranjan Acharya ◽  
Dinesh K Lamsal ◽  
Niraj Karmacharya ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Cardiovascular Complications ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Increased Risk

Introduction Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with increased risk of cardiovascular complications requiring close follow-up and more aggressive treatment. Hence, the present study was done to study the prevalence of diabetes and dyslipidemia in young hypertensive patients i.e. <40 years in a tertiary care hospital, Nepal. MethodsThis is a hospital based cross-sectional study carried out in Civil Service Hospital, Kathmandu. Study included 165 patients of <40 years who had hypertension, either newly diagnosed or undergoing antihypertensive treatment from September 2018 to September 2019. Blood pressure was measured two times on right upper arm in sitting position at interval of 30 minutes and the aver­age was taken. Fasting Lipid Profile and Fasting Blood Glucose was measured after 12 hours of fasting and the prevalence of dyslipidemia and diabetes were analyzed from the data collected. All calculations and statistical analyses are processed by the SPSS 25.0. ResultsAmong 165 patients included, majority of patients, 107 (64.8%) were among 31-39 years, followed by 53 (32.1%) patients among 21-30 years. In total, 98 (59.4%) were male and 67 (40.6%) female. The prevalence of diabetes was 24 (14.5%) and pre-diabetes was 49 (29.7%). The prevalence of dyslipidemia was 125 (75.6%), high triglyceride being the most common disorder followed by low HDL in 87 (52.1%). Elevated total cholesterol was found in 53 (32.1%) patients and 48 (29%) had high LDL cholesterol level. ConclusionA high prevalence of diabetes, pre-diabetes and dyslipidemia was observed in the hypertensive patients <40 years of age.

scholarly journals Overview of Preoperative Cardiology Consultation at a Tertiary Care Centre

2019 ◽  
Vol 21 (3) ◽  
pp. 173-177
Author(s):  
S. Thapa ◽  
M. Basnet
Keyword(s):  
Risk Index ◽  
Tertiary Care ◽  
Cardiac Risk ◽  
Cross Sectional Study ◽  
Cardiac Events ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Increased Risk ◽  
Co Morbidity ◽  
New Diagnosis

Preoperative cardiac consultations are regularly performed during pre-anaesthetic checkup. However, the efficiency and usefulness of these consultations are unclear. The objective of this study is to assess the indication and usefulness of preoperative cardiac consultation. In this cross sectional study, 100 patients sent for preoperative cardiac consultation were evaluated. Baseline characteristics, Revised Cardiac Risk Index (RCRI), comorbidities were recorded. The motive for referral and outcome of the consultation were evaluated. Evaluated patients consist of male (45%) and female (55%) with age ranging from 18 to 89 years (average 51.28 ± 14.6 years). Most common co morbidities were hypertension (53%) and diabetes (30%). High proportion (49%) of patients we resent for cardiac consultation with suspicion of abnormal ECG. Most of the patient had RCRI of 0 and1 (45% and 28% respectively), while 14% and 13% had RCRI of 2 and 3 respectively. “Clearance for surgery” was the most common reason for consultation (60%) followed by risk stratification (41%) and optimization of cardiac disease (40%). Twenty four percent of patients were sent with suspicion of cardiac co morbidity. Twenty six percent were sent without any specific cause. Only 27% of the patient had increased risk of major adverse cardiac events. Further management was not needed in 58% patients. Only 12% patients had a new diagnosis. Preoperative cardiac consultation can be useful in detecting newer cardiac comorbidities and optimization in some patients. However, most preoperative cardiac consultation does not alter the perioperative management

scholarly journals A clinicopathological study of gestational trophoblastic disease in a tertiary care centre of southern Assam

2021 ◽  
Vol 9 (4) ◽  
pp. 1169
Author(s):  
Sailendra K. Thakuria ◽  
Monoj K. Deka ◽  
Shah A. Sheikh
Keyword(s):  
Histopathological Examination ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Trophoblastic Disease ◽  
Increased Risk

Background: Gestational trophoblastic disease (GTD) covers a wide spectrum of benign and malignant conditions that arise from pregnancies with abnormal trophoblastic tissue development. It is a source of significant morbidity as well as increased risk of mortality from their complications if not identified and treated early enough. Our study aimed at the various clinicopathological features of GTDs along with their prevalence in a tertiary care centre.Methods: It was a retrospective cross-sectional study conducted over a period of 3 years from January 2017 to December 2019. All GTD cases were retrieved from department registries and analysed.Results: Out of 60 diagnosed cases of GTDs, 57 cases (95%) were Hydatiform mole. Invasive mole and choriocarcinoma were 2 cases (3%) and 1 cases (2%) respectively. Age ranged from 18-37 years. The most commonly affected age group was 20-25 years with 33 cases (55%). Most cases were presented in the first trimester presenting with bleeding per vagina. The majority of GTD cases belonged to blood group A and 50,000-<1,00,000 mlU/mL beta HCG level.Conclusions: Histopathological examination is helpful for confirmation of diagnosis.It is very important to follow up of such patients for early diagnosis of malignant trophoblastic tumors.

scholarly journals Validity of Bilirubin Measured by Biliscan (Smartphone Application) in Neonatal Jaundice – An Observational study

2021 ◽  
Vol 41 (1) ◽  
pp. 93-98
Author(s):  
Swapna Lingaldinna ◽  
Kalyan Chakravarthy Konda ◽  
Narahari Bapanpally ◽  
Madireddy Alimelu ◽  
Himabindu Singh ◽  
...  
Keyword(s):  
Observational Study ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Smartphone Application ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Non Invasive ◽  
Gestational Age At Birth

Introduction: Bilirubin is a frequently ordered investigation in neonatal intensive care units and out-patient practice during follow- up. The gold standard for its estimation is serum bilirubin which is invasive resulting in parenteral apprehension, pain, discomfort and iatrogenic anaemia in a neonate, while the non-invasive measurement by transcutaneous bilirubinometer is not available in all the centres because of its cost. Biliscan is a smartphone application that uses a phone’s inbuilt camera and a colour calibration card to detect neonatal jaundice. We compared bilirubin measured by Biliscan with reference to serum bilirubin among neonates admitted to a tertiary care centre. Methods: We conducted an observational study from June-2019 to September-2019 at a tertiary care centre in Hyderabad, India. Inborn neonates (greater than > 35 weeks gestational age at birth, and less than a week old) who required bilirubin estimation, underwent both invasive serum sampling and non-invasive estimation by Biliscan. Photograph of the baby’s chest was captured using the colour calibration card of the Biliscan application. Bilirubin values derived from the Biliscan application were compared to those derived from blood samples. Results: A total of 143 neonates were enrolled. The mean bilirubin value estimated by serum sampling was 11.9 g/dl against 13.1 g/dl of that derived from smartphone application. Biliscan and serum bilirubin showed moderate agreement with a correlation coefficient of 0.6. Bland- Altman plot constructed showed bias of 1.1 with the limits of agreement ranging from -3 to +5.3. Biliscan had a good sensitivity of 90% in identifying high levels of serum bilirubin (> 95th percentile on Bhutani nomogram). Conclusion: Biliscan application is a non-invasive, real-time, inexpensive and an easily available method that cannot replace serum bilirubin, however can complement and has the potential to help in screening neonates thus facilitating recognition of jaundice early and minimising the number of invasive pricks.

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