OBSTETRIC OUTCOME IN SHORT STATURED WOMEN- A TERTIARY CARE REFERRAL CENTRE EXPERIENCE FROM SOUTH INDIA
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BACKGROUNDMaternal height is one of the parameters which significantly affects the obstetric performance.Short statured women may have small pelvis and are reported to have higher rates of perinatal mortality, low birth weight and operative delivery.Objective-To find out the relationship between maternal height and obstetric outcome with emphasis on the mode of delivery and neonatal outcome. MATERIALS AND METHODSThis Descriptive study was carried out in the Department of Obstetrics and Gynaecology, Institute of Maternal and Child Health (IMCH), Govt.Medical College, Kozhikode, over a period of one year from November 2007 to October 2008.Since the study duration was short, we had to limit the sample size for convenience.Primigravida having singleton pregnancies, cephalic presentation and sure date of LMP with no medical and obstetric complications were selected from antenatal clinic of IMCH.Those with height < 145 cm formed and those with height > 145 cm formed were considered.A semi-structured proforma which contain demographic, antenatal and anthropometric details as well as obstetric and neonatal outcomes were recorded.Pregnancy and foetal outcome were compared using student's 't' test and chi-square test. RESULTSOut of 467 primigravida, 227 women with height < 145 cm formed the study group and the rest 240 formed the control group.The incidence of LSCS in short women was 32.1% compared to 10% in tall women (p < 0.001), which is highly significant.In short statured women, 53% had LSCS due to CPD, whereas in taller women 25% had LSCS for CPD (Z= 4.525, P < 0.0001).CPD was the indication for LSCS in 71.4% of mothers with height < 135 cm and the percentage of CPD decreased with increase in the maternal height.Significant number of babies born to short statured mothers were asphyxiated (11% vs 3.33%) and required NICU admission (17.6% vs 4.58%) in comparison to babies born to mothers of control group. CONCLUSIONWomen with short stature are high-risk population for poor pregnancy outcome.Short statured women are more likely to undergo LSCS for CPD and their babies are more asphyxiated at birth with higher rate of NICU admissions.The need for anthropometric assessment, partographic monitoring, prompt identification of CPD and early possible caesarean section as well as prompt neonatal care are crucial in the prevention of adverse maternal and perinatal morbidity in short statured women.Keywords:
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BACKGROUND: Cataract is a major cause of vision impairment in many low-income settings. Cataract blindness is a disease which has severe economic repercussions and adversely affects the productivity of country. However, despite rapid increase in the availability of quality services, surgical acceptance is still low in some segments of society. AIM: To study the various reasons for delayed utilization of cataract surgery. METHODS: In this cross sectional study 450 patients above 40 years of age who were admitted in ophthalmology ward for cataract surgery were enrolled by systematic random sampling technique. Socio-demographic data was collected by interviews in local language on predesigned and semi structured proforma. The various reasons for delayed utilization of cataract surgery were asked to them. Statistical tests applied were chi square test and percentages. RESULTS: Majority of the study subjects were illiterate females above 60 years of age belonging to lower socioeconomic status. Most of the study subjects were Hindus from rural area having unilateral blindness. The various reasons for delayed utilization of cataract surgery were economic problems (76.7%), ignorance by patient (29.1%), fear of operation (26.4%), ignorance by head of family (22.4%) and suspicion about improvement of vision after surgery (21.5%). Some subjects gave reasons as lack of accompanying person, fear of surgery causing death, lack of time, its God will and lack of transport. CONCLUSION: The predominant reason for delayed utilization of cataract surgery was economic constraints. Other reasons were ignorance by patients and head of family, fear of operation and death, suspicion about improvement of vision, God's will, lack of accompanying person and lack of transport.
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Orchidopexy for undescended testis is recommended at a younger age than heretofore; our study aimed to assess delays, and their causes, by retrospective analysis of data from a single tertiary care centre over one year (2015-2016). Almost 80% of children were brought after 1 year of age, mostly because of delayed referral by primary physicians (60%), or missed diagnosis by parents or primary physicians (20%). Misconception about the risk of surgery below 1 year was significant (15%). A timely referral is encouraged.
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Objectives. The gastrointestinal tract (GIT) is affected in up to 90% of patients with SSc to a variable extent and severity. We aimed to establish the frequency and range of gastrointestinal (GI) symptoms in SSc patients at the Royal Free Hospital, a tertiary referral centre.
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BACKGROUNDAbdominal tuberculosis is a highly endemic entity.In our country, intestinal tuberculosis is the single largest cause of intestinal obstruction.It has an insidious course, therefore a high index of suspicion is required for an early diagnosis and treatment.Abdominal tuberculosis is managed non-operatively as well as by operative interventions along with ATT (Antitubercular Treatment). Aim of this study:To define most suggestive clinical features of abdominal tuberculosis.To evaluate the usefulness of normally available investigations.To see the response of ATT in abdominal tuberculosis.To evaluate the usefulness of various operative interventions done for abdominal tuberculosis. MATERIALS AND METHODSThis prospective descriptive study of 78 patients, who presented with a clinical diagnosis of abdominal tuberculosis, was conducted in Department of Surgery, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, over a period of one year from May 2015 -April 2016.The criteria for diagnosis of abdominal tuberculosis were clinical suspicion, laboratory findings, operative findings, proven histopathology, demonstration of AFB in specimens and response to antituberculosis drugs.All patients were treated either surgically or non-surgically along with ATT.Patients were followed up for a period of six to twelve months or till death whichever was earlier. CONCLUSIONSThe signs and symptoms of intestinal tuberculosis are nonspecific and there are no unequivocal diagnostic features either clinically or radiologically.The most common presenting complaint was abdominal pain (92%) and the most common sign was abdominal tenderness (69.2%).Most common age group being the 3rd decade of life contributing 35.89% of the total sample size.The most common mode of presentation was that of subacute intestinal obstruction (44%).The most common site involved was small intestine and ileocaecal region (71.8%).48.7% patients were managed non-operatively and 51.3% patients were managed operatively.Firstline antitubercular drugs were given to all patients for 6-12 months period.With the aim of saving maximum bowel length, limited resection was performed in 30% operative cases in the present study, which was second to adhesiolysis (35%), while only 5% cases underwent right hemicolectomy.All patients with abdominal tuberculosis responded well to ATT.
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Background: Stroke is the leading cause of disability and second leading cause of death globally. Carotid artery stenosis accounts for 10-15% of ischaemic strokes. Carotid endarterectomy (CEA) is a surgical method of stroke risk reduction in patients with high-grade stenosis. Best evidence recommends CEA within 14 days of an acute neurological event in patients with ipsilateral stenosis >70% to confer maximum preventative benefit.
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Background: Haemoptysis is an alarming symptom, and the management depends upon the aetiology.The etiology of hemoptysis in various studies is based on the geographic location, the patient population studied, the diagnostic tests employed and the time of publication.Although exact percentages vary in large general populations, bronchiectasis, tuberculosis, and bronchogenic carcinoma are the leading causes of hemoptysis Methods: We prospectively evaluated 175 patients with haemoptysis admitted to the department of respiratory medicine pariyaram medical college, kannur, kerala., for 1 year.Results: Among them 160 (91.4%) were males and 15(8.6) were female.The mean age of presentation was 57.31+/13.57.Sputum was positive for AFB in 12% cases.Chest x-ray was abnormal in 94.25% cases.Fibrosis was the most common abnormality (22.28%) followed by consolidation (21.14%)%).Fibreoptic bronchoscopy (FOB) was done in 75 (42.85%)patients CT done in 100 cases.Final diagnosis obtained in 165 cases.Most common cause was found to be due to Pulmonary TB and its sequelae,84 cases(50.9%).Conclusion: Even in patients with history of ATT, hemoptysis doesn't always reflect underlying pulmonary TB or its sequelae.Hence proper diagnostic work up should be under taken in those cases also.Careful assessment of aetiology is essential to provide proper treatment.
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