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Analysis of cesarean section using Robson's ten group classification system in a tertiary care center from Southern India: A cross-sectional study 分析剖宫产使用罗布森的十组分类系统在三级保健中心从印度南部:横断面研究
Pub Date : 2021-07-01 DOI: 10.4103/ijamr.ijamr_152_21
Kanmani Murugesan, S. Rengaraj
Background: The rising cesarean section (CS) rate is a global concern and World Health Organization in 2015 has proposed the use of Robson-10 group classification system as a standard for assessing and monitoring CS both within and across the healthcare facilities. Objective: The objective is to analyze the CSs performed in a teaching hospital using Robson 10-group classification system. Methodology: The present cross-sectional study was done over a period of 1 year from May 2017 to April 2018. All eligible women delivered in JIPMER, a tertiary care referral center during the study period were classified as per Robson Ten-Group classification system. Caesarean delivery rates were reported. The relative and absolute contribution to CS rates in each groups were calculated. Epi data V.3.1 was used for data analysis. Results: Among 16,863 women delivered during the study, the CS rate was 21.4%. The three common indications for CS overall were fetal distress, nonprogress of labor, and cephalopelvic disproportion. Group 1 (nulliparous, singleton, term cephalic, spontaneous labor) was the largest size followed by group 2 (nulliparous, singleton, term cephalic, induced labor) with 25% and 16.9%, respectively. The maximum contribution of CS was by group 5 (multiparous women, singleton, term cephalic, previous uterine scar) followed by group 2 with 34.9% and 18.9%, respectively. Conclusion: Robson group 5, 2, and 1 were the major contributions to CS in our hospital. Further studies are needed to study the appropriateness of indications for CS especially in groups 2 and 1 as they are the future group 5.
背景:剖宫产(CS)率的上升是一个全球关注的问题,世界卫生组织在2015年提出使用Robson-10组分类系统作为在医疗机构内部和整个医疗机构评估和监测CS的标准。目的:应用Robson 10分组分类系统对某教学医院实施的CS进行分析。方法:本横断面研究于2017年5月至2018年4月进行,为期1年。研究期间,在三级护理转诊中心JIPMER分娩的所有符合条件的女性都按照Robson Ten Group分类系统进行了分类。报道了剖腹产率。计算各组对CS发生率的相对和绝对贡献。Epi数据V.3.1用于数据分析。结果:在研究期间分娩的16863名妇女中,CS发生率为21.4%。CS的三个常见指征是胎儿窘迫、分娩不进行和头盆不平衡。第1组(无产仔、单胎、足月产、顺产)规模最大,其次是第2组(无产仔、单例、足月产和引产),分别占25%和16.9%。CS的最大贡献是第5组(多胎女性、单胎、足月头畸形、既往子宫瘢痕),其次是第2组,分别为34.9%和18.9%。结论:罗布森组5、2、1是我院CS发生的主要原因。需要进一步的研究来研究CS适应症的适当性,特别是在第2组和第1组,因为它们是未来的第5组。
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引用次数: 2
New beginnings and new challenges 新的开始和新的挑战
Pub Date : 2021-07-01 DOI: 10.4103/ijamr.ijamr_229_21
V. Kate, V. Menon
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引用次数: 0
Human dirofilariasis: An emerging zoonotic nematodal infection - A case series 人类dirofilasis:一种新出现的人畜共患线虫型感染——一系列病例
Pub Date : 2021-07-01 DOI: 10.4103/ijamr.ijamr_259_20
Linta Jacob, Nevil Varghese, A. Menon, A. Vinayakumar
Dirofilariasis is an emerging parasitic infection caused by Dirofilaria spp., a parasite carried by domestic dogs, cats, and other wild animals. Humans become accidental dead end hosts when inoculated with microfilariae by blood sucking arthropods like mosquitoes. Subcutaneous dirofilariasis is an accidental human infection that presents as subcutaneous nodules in the body resulting from an inflammatory reaction in response to the infection. We report a case series of human dirofilariasis to highlight its increasing trend from a tertiary care hospital in Kerala, South India.
钩丝虫病是由钩丝虫引起的一种新出现的寄生虫感染,这种寄生虫由家养的狗、猫和其他野生动物携带。当像蚊子这样的吸血节肢动物接种微丝虫时,人类成为意外的死角宿主。皮下dirofilaria病是一种意外的人类感染,由于对感染的炎症反应而在体内表现为皮下结节。我们报告一个病例系列的人类双丝虫病,以突出其增加趋势从三级保健医院在喀拉拉邦,印度南部。
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引用次数: 0
Hypoparathyroidism in pregnancy 妊娠期甲状旁腺功能减退
Pub Date : 2021-01-01 DOI: 10.4103/ijamr.ijamr_223_20
A. Coumary, Samya Janarthanam, T. Dutta, S. Habeebullah
Hypoparathyroidism is a disorder rarely observed during pregnancy. It poses a major challenge in managing a patient appropriately to prevent maternal and fetal complications. We report a case of a 21-year-old gravid woman, a diagnosed case of hypoparathyroidism. She was successfully treated with calcium and calcitriol before pregnancy. Dosage was adjusted according to serum calcium values, and she delivered a healthy baby with normal serum calcium level.
甲状旁腺功能减退症是一种罕见的妊娠期疾病。它对适当管理患者以预防孕产妇和胎儿并发症提出了重大挑战。我们报告一例21岁的孕妇,诊断为甲状旁腺功能减退症。她在怀孕前成功地接受了钙和骨化三醇的治疗。根据血清钙值调整剂量,她产下了一个血清钙水平正常的健康婴儿。
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引用次数: 0
Contemplate enteroviral etiology: Not all neonatal sepsis syndromes are bacterial 考虑肠道病毒病因:并非所有新生儿败血症综合征都是细菌性的
Pub Date : 2021-01-01 DOI: 10.4103/IJAMR.IJAMR_143_20
Femitha Pournami, Mandya Alok Kumar, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain
Sepsis is one of the most common clinical diagnosis made in neonatal intensive care units. However, there are not so uncommon situations when the laboratory results do not support bacterial infections. Viral infections are under-recognized and often missed in sick neonates. We describe a case series of neonatal nonpolio enteroviral sepsis confirmed by the polymerase chain reaction. Although the first patient expired, early recognition of etiology in the index case helped control an outbreak.
败血症是新生儿重症监护室最常见的临床诊断之一。然而,当实验室结果不支持细菌感染时,并不罕见。病毒感染在患病新生儿中被低估,并且经常被忽视。我们描述了一系列经聚合酶链式反应证实的新生儿非脊髓灰质炎肠道病毒败血症病例。尽管第一例患者已死亡,但早期识别指标病例的病因有助于控制疫情。
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引用次数: 0
Prevalence of ABO blood group phenotypes and antibody titers of the blood donor population in and around Puducherry 普杜切里及周边地区献血人群ABO血型表型和抗体滴度的流行
Pub Date : 2021-01-01 DOI: 10.4103/ijamr.ijamr_8_21
S. Gopal, Sujitha Kannan, Rajendra Gurunath Kulkarni, A. Basavarajegowda
Background: For any blood transfusion services, knowing the prevalence and distribution of blood groups in their corresponding geographical area is essential. Hence, this study was done to know the prevalence and distribution of the ABO blood group and the antibody titer levels of blood donors at a premier tertiary care center in Southern India. Methodology: This was a cross-sectional study conducted over 22 months from September 2015 to June 2017 in the Department of Transfusion Medicine, JIPMER, Puducherry, among blood donors in a single tertiary care teaching hospital blood center. The ABO blood group and Rhesus factors (Rh) were determined by the antigen-antibody agglutination test by the test tube method. Titration of anti-A and anti-B antibodies was also done for selected “O” group donors by the doubling dilution technique in the tube method. Results: It was found that the most common blood group in our blood donor population was the “O” blood group with 11,904 (38.43%) followed by “B” 10,643 (34.37%), “A” 6,201 (20.02%), and “AB” 2,219 (7.17%). We had 4 Bombay blood group donors during the study period (0.01%). A titer of 1:32 was the most frequently encountered for IgM anti-A and anti-B antibodies; in Group “O” donors and IgG antibodies, it was 1:8. Conclusion: The prevalence of ABO in and around Puducherry is comparable to those published from other regions in Southern India, with the “O” group being the most common. The distribution of antibody titers for anti-A and anti-B is similar to other studies in India.
背景:对于任何输血服务机构来说,了解相应地理区域内血型的流行情况和分布是至关重要的。因此,本研究是做了了解流行和ABO血型的分布和抗体滴度水平的献血者在印度南部的一级三级保健中心。方法:这是一项横断面研究,于2015年9月至2017年6月在普杜切里市JIPMER输血医学部进行,为期22个月,在单一三级保健教学医院血液中心的献血者中进行。采用试管法抗原抗体凝集试验测定ABO血型和恒河因子(Rh)。对选择的“O”组供者,用试管倍率稀释法进行抗a抗体和抗b抗体的滴定。结果:我国献血者中最常见的血型为O型血11,904人(38.43%),其次为B型血10,643人(34.37%),A型血6,201人(20.02%),AB型血2,219人(7.17%)。在研究期间,我们有4名孟买血型献血者(0.01%)。IgM抗A、抗b抗体滴度最高为1:32;在O组和IgG抗体中,这一比例为1:8。结论:普杜切里及其周边地区的ABO患病率与印度南部其他地区相当,其中“O”型最为常见。抗a和抗b的抗体滴度分布与印度的其他研究相似。
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引用次数: 1
Clinical profile of children with influenza a and b infections admitted to a tertiary care hospital in South India 南印度一家三级医院收治的甲型和乙型流感感染儿童的临床概况
Pub Date : 2021-01-01 DOI: 10.4103/IJAMR.IJAMR_198_20
J. Arul, S. Ponnarmeni, Sharmila Ferdinamarie, R. Dhodapkar, Peter Prasanth Kumar Kommu
Background: The influenza pandemics have caused serious morbidity and mortality around the world. Only a few studies have described the clinical profile of both influenza A and B infections among children and its seasonal variations. Aims: To study the clinical profile of children with influenza (A and B) admitted to a tertiary care hospital in India over a period of 17 months. Methods: A retrospective case file review was done for all influenza-positive cases (by real time-polymerase chain reaction) admitted in the ward and pediatric intensive care unit of a tertiary care hospital from January 2018 to May 2019. Results: A total of 164 admitted children were screened for influenza, of which 41 children (25%) were positive. Seasonal variation showed highest peak in the month of October with 17 positive cases (41%). Influenza B was observed during the first half of the year 2018 followed by an increase in influenza A infection in the last 6 months. The common presenting symptoms were cough (16, 39%) and respiratory distress (21, 51%). Out of 41, 18 children (44%) required respiratory support, but only 2 (5%) required mechanical ventilation. Hyponatremia was present at admission in 13 (61%) of 21 (51%) tested samples. The median length of hospital stay in the admission hyponatremia group was 7 days (interquartile range [IQR] 4, 15) as compared to the overall median length of stay of 4 days (IQR 3, 7). Conclusions: Our study showed a predominance of influenza B in the first half of the year and influenza A infection during the second half. A similar pattern was also seen in the first half of the subsequent year. Further studies are required to understand the impact of hyponatremia in these patients.
背景:流感大流行在世界范围内造成了严重的发病率和死亡率。只有少数研究描述了儿童甲型和乙型流感感染的临床特征及其季节性变化。目的:研究在印度三级医院住院17个月的流感(A型和B型)儿童的临床概况。方法:回顾性分析2018年1月至2019年5月在某三级医院病房和儿科重症监护室收治的所有流感阳性病例(实时聚合酶链反应)。结果:164例入院儿童接受流感筛查,其中41例(25%)呈阳性。季节变化以10月为高峰,有17例阳性病例(41%)。2018年上半年观察到乙型流感,随后在过去6个月甲型流感感染有所增加。常见的临床表现为咳嗽(16.39%)和呼吸窘迫(21.51%)。在41例患儿中,有18例(44%)患儿需要呼吸支持,但只有2例(5%)患儿需要机械通气。21例(51%)检测样本中有13例(61%)入院时出现低钠血症。入院低钠血症组的住院时间中位数为7天(四分位数差[IQR] 4,15),而总体住院时间中位数为4天(IQR 3,7)。结论:我们的研究显示,上半年以乙型流感为主,下半年以甲型流感为主。随后一年的上半年也出现了类似的情况。需要进一步的研究来了解低钠血症对这些患者的影响。
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引用次数: 1
Why must faculty members in medical institutions engage in research? 为什么医疗机构的教职员工必须从事研究?
Pub Date : 2021-01-01 DOI: 10.4103/ijamr.ijamr_105_21
Rakesh Aggarwal
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引用次数: 0
Operating room preparedness to manage future pandemics of airborne infectious diseases: What is needed? 手术室应对未来空气传播传染病大流行的准备工作:需要什么?
Pub Date : 2021-01-01 DOI: 10.4103/ijamr.ijamr_88_21
M. Mohta, G. Chilkoti
The entire world has been in the grip of COVID-19 for more than a year and is susceptible to have further pandemics in future. Although elective surgical procedures should be postponed in infected patients, they may require emergency surgeries. At the beginning of the COVID-19 pandemic, most operating room (OR) setups were not as per the requirements. Hence, several modifications and innovations were made to handle the situation. The existing ORs were converted temporarily into COVID ORs using these modifications. However, now it is well understood that the world is quite susceptible to these types of infectious diseases, and special ORs will be required for surgical management of infected patients. Therefore, it becomes extremely important to prepare dedicated ORs for emergency surgeries in patients with airborne infectious diseases, which can be readily used to manage infected or suspected patients in the event of any future pandemic. We aim to review the current relatively scarce literature and answer some questions about the readiness and methods required for conducting safe surgery during the COVID-19 pandemic, as well as any other such pandemic in future. The preparations are needed in the field of infrastructure, staff requirements and management, equipment and other supplies, and formulation of guidelines for clinical management. The ultimate aim is to prevent spread of infection from the patient to the staff members, OR environment, and other patients without compromising the care of the infected patient. This review highlights these issues and also discusses specific concerns in some special patient populations.
一年多来,整个世界都被COVID-19所控制,未来很可能发生进一步的大流行。虽然感染患者的选择性外科手术应推迟,但他们可能需要紧急手术。在新冠肺炎大流行初期,大多数手术室的设置不符合要求。因此,进行了一些修改和创新来处理这种情况。使用这些修改将现有的or暂时转换为COVID or。然而,现在人们很清楚,世界上很容易受到这些类型的传染病的影响,对感染患者的手术治疗需要特殊的手术室。因此,为空气传播传染病患者的紧急手术准备专门的手术室变得极其重要,这可以在未来发生任何大流行时随时用于管理感染或疑似患者。我们的目标是回顾目前相对稀缺的文献,并回答有关在COVID-19大流行期间以及未来任何其他此类大流行期间进行安全手术所需的准备和方法的一些问题。在基础设施、工作人员需求和管理、设备和其他用品以及制定临床管理准则方面需要进行准备。最终目的是防止感染从患者传播到工作人员、手术室环境和其他患者,同时不影响对受感染患者的护理。本综述强调了这些问题,并讨论了一些特殊患者群体的具体问题。
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引用次数: 0
Life skills of adolescent girls in relation to their self-concept developed through kishori panchayat: An adolescents for health action model 通过“促进青少年健康行动模式”发展的青春期女孩与其自我概念相关的生活技能
Pub Date : 2021-01-01 DOI: 10.4103/IJAMR.IJAMR_211_20
Ishita Guha, C. Maliye, Subodh S. Gupta, B. Garg
Background: The Adolescents for Health Action model: Kishori Panchayat (KP) is a novel community participation approach for mobilizing and empowering adolescent girls. The model is expected to improve life skills of adolescent girls not only through occasional life skills sessions but also by providing them a platform for interaction with peer-groups, villagers and health-care providers, sharing experiences, community level health, and social activities. Objective: We aimed to assess whether life skills of KP girls are better in comparison to non-KP girls aged 12–18 years. Methodology: A cross-sectional study was carried out among 100 KP and non-KP girls, respectively, of aged 12–18 years, selected using random lottery method over 1-year period under Anji and Waifad Primary health center areas (10 villages from each) of rural Wardha, Maharashtra. Validated self-administered scales for communication skill, critical thinking, decision-making, problem-solving, and self-esteem were used. Written consent from participants and permission from institutional ethics committee were taken. Results: The mean life skill scores were better among KP girls compared to non-KP with a significant difference (P < 0.001) in both groups regarding communication skill, critical thinking skill, decision-making, problem-solving, self-esteem, and total life skill scores. Conclusion: Community-based adolescents for health action model for the rural adolescent girls can empower and enhances their life skills with minimum resource and intensive effort.
背景:青少年促进健康行动模式:Kishori Panchayat(KP)是一种新的社区参与方法,旨在动员少女并赋予其权力。该模式有望提高少女的生活技能,不仅是通过偶尔的生活技能课程,还为她们提供了一个与同龄人、村民和医疗保健提供者互动的平台,分享经验、社区一级的健康和社会活动。目的:我们旨在评估与12-18岁的非KP女孩相比,KP女孩的生活技能是否更好。方法:在马哈拉施特拉邦瓦尔达农村的安吉和威法德初级卫生中心地区(每个地区10个村庄),分别对100名12-18岁的KP和非KP女孩进行了一项为期1年的横断面研究。使用了经过验证的沟通技能、批判性思维、决策、解决问题和自尊的自我管理量表。获得了参与者的书面同意和机构道德委员会的许可。结果:KP女孩的平均生活技能得分高于非KP女孩,两组在沟通技能、批判性思维技能、决策、解决问题、自尊和总生活技能得分方面均有显著差异(P<0.001)。结论:以社区为基础的农村少女青少年健康行动模式可以用最少的资源和密集的努力来增强和提高她们的生活技能。
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引用次数: 0
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International Journal of Advanced Medical and Health Research
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