A five-year study of postpartum exploratory laparotomy in a tertiary care teaching hospital

Background: Emergency postpartum exploratory laparotomy is a major surgical venture invariably performed in the setting of life threatening conditions during or immediately after abdominal and vaginal deliveries. Tertiary health care centers play a prime role in such cases to avoid any mishap. In spite of that sometimes sudden such incidences in the form of maternal morbidity or mortality occur which makes us think upon.Methods: A retrospective study was conducted in Dr. SCGMC, Nanded, a tertiary health care centre in Nanded Maharashtra, over a period of 5 years in the Department of OBGY i.e. between January 2012 to December 2016 of the cases who required postpartum exploratory laparotomy.Results: Out of the total deliveries in our hospital and cases referred from outside hospital from January 2012 to December 2016 i.e a span of 5 years including 62525 cases under study, 39 cases required postpartum exploratory laparotomy. We found that postpartum hemorrhage is the most common cause requiring postpartum exploratory laparotomy. Other causes requiring postpartum exploratory laparotomy are burst abdomen, puerperal sepsis, rectus muscle hematoma etc.Conclusions: In the era of modern obstetrics, to fulfill the main objective of obstetrics of having healthy mother and healthy baby at the end of pregnancy, postpartum exploratory laparotomy is a procedure done as an extreme measure to reduce maternal mortality and morbidity. We observed that majority of the patients who required exploratory laparotomy in postpartum period suffered morbidity in the form of prolonged hospital stay or transfusion of blood or blood products, need of ventilator support or ICU care. Though the patients suffered morbidity, mortality could be prevented by timely intervention in majority of the patients

Clinical study of post partum haemorrhage from a teaching hospital in Maharashtra, India

Background: To study the cases of postpartum haemorrhage, their causes and management in a tertiary care centre.Methods: A retrospective study of cases of postpartum haemorrhage for a period of 3yrs was conducted in Dept. of OBGY at a rural tertiary care center and teaching hospital in Maharashtra. The major causes, management modalities, morbidity and mortality associated with it were discussed.Results: Out of 37515 deliveries over the period of 3 years (2014-2016), there were 1333 cases of PPH out of which accounted for a prevalence of 3.55%. Study showed that 86% of cases were due to atonic PPH, 9.9% due to traumatic PPH, and 0.97% were due to both atonic and traumatic PPH. 2.7% of cases were due to retained placenta, 0.07% were due to bleeding diathesis.Conclusions: In an era with availability of excellent uterotonics and active management of 3rd stage of labour even today postpartum haemorrhage stands first as the cause of maternal morbidity and mortality. Even though with excellent medical and surgical interventions, maternal mortality due to PPH has been significantly reduced, the field still needs extensive research and new modalities to prevent and manage post-partum haemorrhage

A multicentre pharmacoepidemiological study of dermatological disorders in Wardha district

Background: Skin diseases are common among the general population and account for a high percentage of all diseases. For considering the increase in the prevalence of specific skin diseases, prevalence data are needed. Appropriate treatment of common diseases and provision of essential drugs are two essential components of the primary health care. The aim in dermatological therapy is to use the safest and least number of drugs in order to obtain the best possible effect in the shortest period at reasonable cost. For that important step is taken to monitor, evaluate and therapeutically analyze the prescribing pattern of dermatological drugs. Methods: 12210 cases were screened for dermatological disorders in the Primary Health Care Centers and Rural Hospital of Wardha district during the time frame 1st January 2006 to 30th September 2010, out of which 1000 patients experienced different variety of dermatological disorders were analyzed. In prescription analysis 800 prescriptions with 1946 drugs were analyzed.Results: The prevalence of dermatological disorders in our study was found 8.19%. Out of 1000 patients, there were 567 females (56.7%) and 433 male (43.3%).1000 cases were divided into five age groups viz. 1-20 yrs, 21-40 yrs, 41-60 yrs, 61-80 yrs and more than 80 yrs. Percentage distribution for the various age ranges were 21%, 48%, 20%, 8% and 3% respectively. In spectrum of dermatological disorders, Acne vulgaris (14.8%) was the most common disorder followed by Tinea infection (13.6%) , Eczema (13.2%), scabies (12.4%) and pyoderma (11.6%), Acute urticaria (6.6%), Melasma (5.8%), Psoriasis (3.8%), Polymorphous light eruption (3.6%), Phytophotodermatitis (2.6%), Leprosy (2%) and other disorders (10%). The total number of drugs prescribed in 800 prescriptions was 1946 i.e. on average 2.43 drugs were prescribed per patient. Out of 1946 drugs, 1054 were topical and 892 were oral preparations. Antifungal was most common topically prescribed drug.Conclusions: The prevalence of dermatological disorders is 8.19 %. Younger age group (21-40 yrs) and Females is most affected by dermatological disorders. The commonest dermatological disorder is Acne and in prescription analysis, antifungals are most commonly prescribed