Background: Postpartum haemorrhage (PPH) is a very common complication that follows delivery. It is one of the leading causes of maternal mortality both in developing and developed countries. Primary PPH has been studied a lot, but data regarding secondary PPH is sparse. Our objective was to study the clinical characteristics and outcome of patients presenting with secondary PPHMethods: A retrospective descriptive study done at Lalla Ded hospital Srinagar, a tertiary care hospital of North India, between June 2015 and December 2015.Results: Fifty patients with secondary PPH were studied out of whom 36 were delivered outside this hospital and referred. Fourteen patients who delivered in this hospital developed secondary PPH. Mean age of patients was 35±3 years. Retained products of contraception (RPOCs) was the leading cause in 36 (72%) of patients followed by endometritis in ten (20%). Mean hemoglobin concentration was 8.7±1.9grams ranging from 4.4 grams to 12.9 grams. Mean hospital stay was 6.3±1.5 days ranging from 1 day to 20 days. Curettage was done in 40 (80%) of patients including 36 having RPOC s and check curettage in four patients. Fourteen (28%) patients required blood transfusion. One patient required hysterectomy. None of the patients died.Conclusions: Secondary PPH has been studied very little. Our results show retained products of contraception as a leading cause of secondary PPH which is probably related to poor management of third stage of labour. There is crucial role of active management of third stage of labour in preventing secondary PPH. Majority of secondary PPH patients require dilatation and curettage with other supportive measures only. Surgical intervention is rarely required. Blood loss is usually mild to moderate. Prognosis is good if medical intervention is sought early.

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Background: Severe Acute Malnutrituon (SAM) is a form of malnutrition where there is an imminent threat of death to the child. The chances of complications are very high and in most case child requires hospitalization for stabilization and rehabiliatation. Objective of study the clinicoepidemiological and laboratory profile of children with severe acute malnutrition (SAM) admitted to a Nutritional Rehabilitation Centre (NRC) of our hospital.Methods: A retrospective chart review of admitted patients. Nutritional Rehabilitation centre (NRC) at GB Pant Hospital Government Medical College Srinagar over a one year period between June 2017 and June 2018.Results: Total of 187 patients of SAM was admitted in NRC during the study period. One hundred and eight (57.7%) were males and 79(42.3%) were females .Patients were equally among various districts. Infants (<12months) constituted the majority of admissions (54.5%). Marasmus was by far the commonest phenotype presenting as SAM (85.5%).Respiratory comorbidity was the commonest present in about  41 (26.3%) followed by daiarrhea in  32(20.5%). Delayed initiation of complimentary feeding was found in 75(40.1%) while early weaning was found in another 55 children (29.4%). Birth order more than three was present in 92 children (49%). Mother’s literacy status had a direct bearing on the prevalence of SAM. Most of the children were from rural background (75%).Most belonged to low economic and income class as around 65.2% had a very meager  family income.Conclusions: SAM is more common in Infants and in children from rural background. It is highly associated with faulty feeding practices including lack of breast feeding and presence of mixed and faulty feeding. It is also associated with increasing birth order, low maternal education and low family income Pneumonia and diarrhea are leading comorbidities. Hypoglycemia and hypothermia are leading complications.  Marasmus is the commonest phenotype.

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Background: Obstetric ICUs have become an important part of any tertiary care obstetric hospital. There have been studies in different parts of the world including India to determine the clinical spectrum, management and outcome of the patients admitted to these units. There have been a few studies on the subject from our part of the country, so we tried to carry out the said study. Our objective was to study indications of admissions, the pattern of complications, interventions required, and the maternal and fetal /neonatal outcome of the patients admitted in an obstetric ICU of our hospital.Methods: A retrospective descriptive study carried out at Lalla Ded hospital Srinagar, a tertiary care hospital of north India, between January 2017 and June 2017.Results: Fifty patients among 4890 obstetric admissions required ICU care giving an admission rate of 1.02%. Most of the patients fell in the age group of 26-30years (52%) followed by 31-35 years (24%).The most frequent indication for admission to ICU was pregnancy induced hypertension related eclampsia and preeclampsia which constituted about 44% (n=22) of the admissions. Obstetric haemorrhage was a close second and accounted for 34% (n=17) of the admissions. Mean ICU stay was 2.5±1 days. Four patients died giving a maternal mortality rate of 8% in this ICU. There were eleven fetal and neonatal deaths excluding ectopic pregnancy giving a fetal /neonatal mortality rate of 22%.Conclusions: Obstetric ICUs have become an important part of any tertiary care obstetric hospital. Significant number of patients get admitted and treated in these ICUs. In our part of the world majority of ICU admissions are because of eclampsia/preeclampsia and obstetric haemorrhage. Although a large number of mothers and their neonates get benefitted by way of admission to ICUs, a significant proportion of these mothers and their neonates die. There is a lot of scope of improvement in maternal and perinatal mortality. In addition to the importance of setting up of state of the art obstetric ICUs, the need for supervision of pregnancies, institutional deliveries, early detection of complications and early referral cannot be overemphasized.