Objective: A study to analyze maternal near miss obstetrics event and maternal mortality in a tertiary care centre. Methods: This was a retrospective analysis of data, from January 2015 to December 2017. For each eligible patient, medical records were reviewed. Their socio-demographic features, mode of delivery, diagnosis on admission, surgical intervention, ICU admission, duration of hospital stay and outcome were collected and analyzed. Results: There were 159 maternal near miss cases and 83 maternal deaths. Maternal near miss to mortality ratio was 1.92. During the study maternal near miss incidence (MNM ratio) was found to be 47. 73 per 1000 live birth. Mortality index in our study was 34.29. There was more than one delay in most of the patients. Delays were primarily in seeking health care and delayed referral. Haemorrhage, hypertensive disorders and rupture uterus are most common cause of maternal near miss in our study. Conclusion: Investigating the maternal near miss cases are important tool to get the information about the causes, identify the gaps and corrective measures to be taken in the health care system.
Background and Objective- Surgical site infections are one of the most common cause of nosocomial infections and second most common cause of maternal mortality next to PPH. Surgical site infection being a relatively serious problem in our health institution, there are scanty published reports on the risk factors that are involved in SSIs in our local hospitals necessitatingfurther research to identify the indispensable factors responsible for high infection rate Methodology- Data were collected prospectively using predefined data collection forms which was developed after review of literature to identify risk factors for SSI. The form included patients demographic features, potential risk factors for SSI. A surveillance system as suggested by the CDC NHSN criteriawere used for diagnosing SSI. SSI was defined as a wound swab culture confirmed infection at the site of surgery within 30 days after an operation . SSI was defined as per NHSN criteria. Data was collected daily on all study participants after obtaining informed written consent, and followed them until discharge. The post discharge surveillance was done by actual patient visit in majority of patients (81%) or by mobile phones Results- Increasing age , increasing parity , anemia , hypertension , diabetes and poor nutrition, obesity were found to be independent risk factors for development of SSI. Conclusion- A proper assessment of identifiable risk factors that predisposes to SSI and their correction may help reduce SSI rates.
Background: Aim of the study was to compare the suture techniques using interrupted mattress and continuous subcuticular and stapler in terms of wound closure time; pain in stitch line on post-operative day 3, 5 and 7 and patient satisfaction. Methods: All patients fulfilling the inclusion criteria, were divided into 3 categories (interrupted mattress, subcuticular and staples) by random selection. Assessment parameters being skin closure time; induration and discharge on day 4 and 8; pain score using visual analogue scale on day 3, day 5 and 7; wound gaping and Patient satisfaction in terms of cosmesis using Likert’s scale after 4-6 weeks. Results: The skin closure time in mattress, subcuticular sutures and staples are found to be 8.891±1.343; 11.390±1.438 and 1.518±0.502 respectively. Pain on day 3, 5 and 7 were: severe pain was maximum seen in staples group (n=21) as compared to 7 patients in subcuticular group and 6 in mattress group. Wound complications were seen least in mattress group. One patient (1.20%) had wound gaping in mattress group, 3 (3.65%) of the patients in subcuticular group and 5 (6.17%) in staples group had wound gaping. Patient dissatisfaction rate was higher in staples group (8.64%) as compared to 6.09% patient in subcuticular group and 4.8% in mattress group. Conclusions: The mattress suturing technique has least wound related complications and most patients satisfaction. Staples are quick in application and subcuticular technique gives a good scar, but is associated with similar complications as staples.
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