1,720,962 research outputs found
Antenatal care during the COVID-19 pandemic
Get PDFBackground: COVID-19 pandemic has affected the daily living globally. It has added to the stress of day to day life. COVID-19 is associated with severe disease in high-risk population groups with increased mortality risk. COVID-19 and it’s impact on pregnancy needs extensive research. Early research data does not suggest any increased risk in the pregnant population and Vertical transmission is yet to be confirmed. As of now no standard protocol is available for management of COVID-19 .Social distancing is the best possible mechanism available to protect patients and health care personnel from COVID-19. The aim of this study is to know the effectiveness of protocol based Antenatal care during COVID-19 pandemic.Methods: This study was conducted at the Antenatal clinic. A total of 40 antenatal cases who satisfied inclusion and exclusion criteria were selected for the above study. They were assessed at the antenatal clinic following a modified protocol.Results: Majority of the pregnant women in the study group were primigravidas and belonged to the age group of 21-25 years. They were called for Antenatal check-ups as per the protocol specifically modified taking into consideration the COVID-19 pandemic. 80% of the deliveries in present study were normal delivery and only in obstetric emergencies LSCS was performed.Conclusions: Antenatal care in COVID-19 pandemic is challenging yet essential. Following a protocol based approach is the key to management of Antenatal care amidst the pandemic. It is cost-effective and has an easy learning curve.
Effectiveness of Cabergoline therapy in hyperprolactinemic infertility
Get PDFBackground: Hyperprolactinemia may be associated with ovulatory dysfunction and resultant subfertility. Hyperprolactinemia affects the pulsatile release of GnRH, which in turn impairs the secretion of FSH and LH. It may also affect the endocrine activity of ovarian follicles, resulting into luteal phase defect and ovulatory dysfunction. Hyperprolactinemia may be associated with infertility in up to one-third of women undergoing infertility workup. Women with hyperprolactinemia are generally treated with dopamine receptor agonists to reduce serum prolactin levels and regularisation of menses. The aim of this study was to study the effectiveness of cabergoline therapy in hyperprolactinaemic infertility.Methods: This prospective study was performed from June 2017 to July 2018 in women with Hyperprolactinemic infertility attending the infertility clinic at INHS Patanjali. In this study, 20 women with hyperprolactinemic infertility who satisfied the inclusion and exclusion criteria were started on four week cabergoline therapy. The effectiveness of therapy was evaluated on the basis of normalization of prolactin levels, regularization of menses, reduction in galactorrhea, successful conception and adverse effects if any.Results: The women on Cabergoline therapy showed marked improvement in menstrual irregularity, near normal prolactin levels and reduced galactorrhea. After the four week Cabergoline therapy the frequency of galactorrhea and irregular menses was reduced in 8 (80%) and 14 (93.3) per cent, of women respectively. Successful conception was achieved in 17 (85%) women after regularization of menses with no any major adverse effects.Conclusions: This study shows the effectiveness of cabergoline therapy both on lowering the serum prolactin levels and successful Conception with no any major adverse effects. Cabergoline therapy is a cost effective and safe option in hyperprolactinaemic infertility
Effectiveness of forceps delivery in modern day obstetrics
Get PDFBackground: There has been an alarming rise in number of caesarean sections all over the world. Instrumental delivery plays an important role to reduce this trend globally. Forceps delivery though proper training and expertise can definitely reduce the rising caesarean section rates in the modern-day obstetrics. The aim of this study is to study the effectiveness of forceps delivery in modern obstetrics.Methods: In the present observational study, 20 cases of forceps delivery were studied for maternal and foetal outcomes including postpartum hemorrhage, perineal tears, Apgar score, NICU admissions, birth injury, and mortality.Results: The most common indication for forceps application was maternal exhaustion (80%) followed by foetal distress. All the cases of forceps application in the present study were associated uneventful vaginal delivery. No any adverse maternal outcomes including perineal tears, post-partum hemorrhage was observed in this study. Average birth weight in the present study was 3.2 kgs and Apgar scores at birth and five minutes was within normal limits. No any birth injury was noted in any of the newborns.Conclusions: Forceps delivery is a safe and effective option in modern day obstetrics to reduce the alarming rise in rates of caesarean section globally. Training should be encouraged to develop the expertise of this art of forceps delivery
Effectiveness of modified mattress suture closing technique over conventional lower segment caesarean section closing technique
Get PDFBackground: The objective of this study was to compare the thickness of the scar and relative thinning of the uterinewall following conventional LSCS closing technique versus new closing technique (modified mattress Suture) and any additional surgical procedure in each group.Methods: A total of sixty patients undergoing primary caesarean for obstetric indications and who were willing for the study were included. In 30 patients uterus was closed by conventional double layer technique (the first layer is suturing with absorbable suture in a continuous running fashion. After first layer is complete, a second continuous stitch is used to invert the first layer, inverting stitch may be horizontal or vertical using same suturing material) and in 30 patient uterus was closed by new modified mattress technique. In both groups same suture material (vicryl 1-0) was used. Measurement of the thickness of scar site and corresponding posterior wall thickness was done following 6 months of caesarean section.Results: The possible parameters of better technique i.e., the mean scar thickness is more and relative as well as percentage thinning is less with this new technique of uterine closure although statistically not significant. Conclusions: Modified mattress suture technique is a single step procedure and gives the feel of double layer uterine closure. Hence the time taken, material. Used and the cost involved will be less along with excellent hemostasis
Effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in pregnancy
Get PDFBackground: Anaemia in pregnancy is very common throughout our country impacting both mother and the newborn. The most common cause of anaemia in pregnancy is iron deficiency. The increased prevalence of iron deficiency anaemia amongst the pregnant women, especially in developing countries is a major cause of significant maternal morbidity and mortality. Intolerance to oral iron, inadequate absorption, and side effects leading to poor compliance are the major shortcomings in oral iron therapy. These factors are significant especially in anaemia near term. To overcome all these limiting factors associated with oral iron therapy, parenteral iron therapy is preferred. Aim of this study was to study effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in pregnancy.Methods: This prospective study was taken up to compare the effectiveness of intravenous iron sucrose over oral iron therapy for anaemia in 30 antenatal women attending antenatal outpatient Department of Obstetrics and Gynaecology belonging to gestational age group of 28-34 weeks with anaemia in pregnancy.Results: Majority of pregnant women belonged to age group of 22-25 years.67% were primigravidas. The period of gestation varied from 28-34 weeks. In this study, the mean baseline haemoglobin was 8.4 g/dl before start of treatment and after iv iron sucrose treatment haemoglobin showed a mean value of 10.8g/dl. The mean baseline MCV was 70 fl/cell. Post treatment MCV after 4 weeks showed a significant mean rise of 12 fl/cell in the present study with no major side effects.Conclusions: Intravenous iron sucrose is highly effective over oral iron therapy for anaemia in pregnancy. It enables rapid correction of anaemia with minimal side effects.</jats:p
Effectiveness of folic acid in unexplained infertility
Get PDFBackground: Folic acid is commonly used by infertile women worldwide. However, studies on the effect of folic acid in women with unexplained infertility are lacking. This aim of this study was to evaluate the effectiveness of folic acid in women with unexplained infertility.Methods: This prospective multicentric study was performed from June 2019 to July 2020 in women with unexplained infertility attending the fertility clinic. In this study, 50 women with unexplained infertility who satisfied the inclusion and exclusion criteria were started on folic acid therapy. The effectiveness of therapy was evaluated on the basis of successful conception and adverse effects if any.Results: Folic acid therapy showed a marked improvement in infertility status measured in terms of successful conception. After initial 12 weeks therapy successful conception was achieved in 40 (80%) women without any adverse effects.Conclusions: Folic acid supplementation has a positive effect on pregnancy outcome in women with unexplained infertility without any adverse effects. Folic acid is thus a safe and cost-effective option in women with unexplained infertility
HOSPITAL ADMINISTRATION IN A PERIPHERAL REMOTE LOCATION HOSPITAL: A EVIDENCE BASED STUDY
No full textObjective: The organisation of the human society has undergone a unique transition throughout the last decades. With the rise of ever growing technologization and disruptive innovations, populations also demand more social and environmental initiatives from firms and governments. In 2015, the United Nations (UN) member states agreed upon a 2030 Agenda for Sustainable Development. Developing a sustainable UHC is decisive to ensure better economic prospects and social equality across socioeconomic classes. This can be achieved by lowering the barriers to access health services to the most vulnerable groups and improve mortality and disability rates in the potential workforce.
Methods: The present study was conducted in a remote location defence hospital catering to the health care needs of serving personnel of Indian armed forces and civilians residing in this peripheral area. The basic specialties including Obstetrics, paediatrics, medicine and general surgery are provided at this centre 24*7 by the dedicated medical officers of Indian Armed forces.
Results: Sustainability of care continuously evolves towards becoming a major factor for public healthcare organisations, and more accountability will likely be demanded of managers to deliver on each aspect of its triple bottom line. This study shows that prevention and patient empowerment both carry great potential to attain this objective.
Conclusion: It is necessary to set priorities and act according to available resources and organisational vision. The central threats to sustainability of public health care welfare systems in peripheral hospitals identified, namely the ageing population and rise in chronic diseases. UHC at a meso and micro level, could provide a much better rationale for scholars to evaluate the need for change, and contribute to draft more inclusive sustainable strategies
The effects of food habits on pregnancy outcome
Get PDFBackground: Nutrition during pregnancy plays an important role for an optimum outcome of pregnancy. Maternal undernutrition can lead to poor intrauterine growth and low weight of the baby at birth. Moreover, the leading causes for maternal deaths like hemorrhage and infection are related directly or indirectly to nutrition. The aim of this study was to study the effects of food habits on pregnancy outcome.Methods: 350 women from the antenatal clinic, who satisfied the criteria were admitted to the study.Results: The majority of pregnant women belonged to the age group of 21-25 years (47%) followed by the 26-30 years age group (40%) and 83% belonged to the low socioeconomic class. Majority of the babies (66%) had the birth weight in the range of 2.5-2.9 kg. There was a significant association (p value <0.05) between the socioeconomic status of the mother, parity and her calorie intake. The present study found a statistically significant association between the maternal nutritional status, the birth weight of the baby and the need for NICU admission (p value <0.05).Conclusions: Maternal food habits have significant effects on the pregnancy outcome.</jats:p
Mifepristone-misoprostol combination in medical termination of early pregnancy
Get PDFBackground: Unplanned and unwanted pregnancies are common worldwide despite of the medical advancements and wider availability of contraceptive methods. The development of safe, effective, inexpensive, nonsurgical methods of abortion is thus highly desirable. Objective of present study was to evaluate the effectiveness of Mifepristone 200 mg orally followed by Misoprostol 800 µg intravaginally 48 hours later in women undergoing medical termination of early pregnancy (up to 63 days of gestational age).Methods: The present study included 100 pregnant women requesting termination of pregnancy in first trimester attending the department of Obstetrics and Gynecology. Women with gestational age up to 63 days from the first day of the last menstrual period with previous regular cycles were studied. Patients without medical or surgical contraindications to Mifepristone and Misoprostol were included.Results: Majority of the pregnant women belonged to the age group between 20-30 years. 30% of these women were nulliparous and 70 % were multiparous. The period of gestation varied from 35-63 days.90% of the patients had complete abortion and 10% had incomplete abortion. All the patients expelled the products of conception within 24 hours of prostaglandin administration. The adverse effects reported were nausea reported by 30%, vomiting by 5 %and diarrhea by 2% of the cases. None of the patients reported excess bleeding at the time of abortion, hospitalization or blood transfusion. This regimen has the effectiveness of complete abortion rate with few side effects.Conclusions: The Mifepristone- Misoprostol combination offers an effective, acceptable, out-patient procedure and an alternative to surgical methods of abortion in medical termination of early pregnancy (up to 63 days of gestation).</jats:p
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