Retrospective Record-based Study Research Articles

Superior mesenteric artery syndrome

Objectives:To determine the prevalence of superior mesenteric artery (SMA) syndrome in patients presenting with abdominal pains, and to evaluate computed tomographic (CT) findings needed for its diagnosis.Methods:This retrospective record-based study was carried out at the radiology department, from January 2016 to January 2021. All young patients (aged under 25) who underwent CT scans for abdominal pains were reviewed. Post-surgery, tumor, and trauma cases were excluded. Imaging findings for SMA syndrome were recorded as ‘suggestive’ (reduced aortomesenteric angle and distance with proximal duodenal dilatation), ‘possible’ (reduced angle and distance without proximal duodenal dilatation) and ‘probable’ (reduction of either angle or distance). Two radiologists interpreted the findings and consensus reporting was made. Diagnoses were confirmed on clinical grounds (symptomatic improvement by specific treatment and exclusion of other diagnoses), or barium studies. Imaging findings were compared to final diagnoses. McNemar’s Chi-square test was used to determine association.Results:Out of 141 patients (mean age=10.8, standard deviation=4), 7 (4.9%) patients mostly females were having SMA syndromes based on ‘suggestive’ imaging criteria (p=0.0005), and one patient underwent surgery.Conclusion:Superior mesenteric artery syndrome is not an uncommon condition and should be considered in differential diagnosis of acute abdomen in young patients after excluding other diagnoses.

Prevalence of Sepsis Continuum in Patients With Type 2 Diabetes Mellitus at Tupua Tamasese Meaole Hospital in Samoa.

BackgroundIndividuals with longstanding type 2 diabetes mellitus (T2DM) have a significantly higher risk for infection caused by immune dysfunction, resulting in sepsis continuum (sepsis, severe sepsis, and septic shock) if not adequately addressed. In sepsis, organ dysfunction occurs because the host’s response to infection is impaired, more so in severe sepsis. In septic shock, persistent hypotension happens, requiring vasopressors despite aggressive fluid management. The internal medicine (IM) ward plays a critical part in managing patients with sepsis. However, the prevalence of sepsis has been investigated extensively in an intensive care unit (ICU) setting instead of the IM ward. This study aimed to determine the prevalence rates of sepsis, severe sepsis, and septic shock in patients with T2DM admitted at an IM ward in Samoa.MethodsThis retrospective hospital record-based study was conducted over four months on 100 patients with T2DM admitted to the IM ward within the sepsis continuum. Participants were selected by convenience sampling, and the diagnosis was determined from the admission notes.ResultsThe prevalence rates of sepsis, severe sepsis, and septic shock in patients with T2DM admitted to the IM ward were 80%, 12%, and 8%, respectively.ConclusionThe most frequent presentation in individuals with T2DM who are within the sepsis continuum upon admission to the IM ward was sepsis, followed by severe sepsis and septic shock.

Psychological and clinical-epidemiological profile of poisoning in Nepal: an institutional experience.

Background Poisoning has become a major public health problem, withthe intent in most cases beingself-harm and commit suicide. This study highlights the psychological and clinical-epidemiological profile of patients visiting Scheer Memorial Adventist Hospital after poisoning. Methods This retrospective record-based study was done among poisoning patients of a hospital in Nepal from 1st January 2018 to 31st December 2020. Data were analyzed using STATA version-15. Results Out of 134 total poisoning cases, 71 had consumed organophosphate compounds.The majority ofthe cases were female (59.2% in organophosphate groups, 69.8% in non-organophosphate groups). The circumstances of poisoning were mostly suicidal (95.8% in organophosphate groups, 90.5% in non-organophosphate groups) and the reasons for thisbeing mostly family disputes. Organophosphate groups had 8.41 times higher odds of having complicationswhencompared tonon-organophosphorus compounds. Conclusions The majority ofthe poisoning cases were suicidal in nature and family disputes being the major reason for the intake of a poisonous substance. This demandsthat moreattentionbe givento psychological and family counseling to resolve any disputes, as well aspsychological management of poisoning cases after medical management. Also, a strong regulatory mechanism should be imposed to control the easy access to poisonous substances.

ABCL-334: Impact of COVID-19 Pandemic on Treatment Duration in Curable Cancers: Comparison of Patients with DLBCL Treated Before and During: A Retrospective Record-Based Study

ContextTreatment delays can compromise outcomes in aggressive hematological malignancies primarily treated with chemotherapy. Due to the burden of the COVID-19 pandemic on healthcare systems, there is a potential risk of delayed therapy of various diseases, including cancers. However, efforts were made in our center (despite being a COVID-19-designated hospital) to ensure that “curative-intent” treatment for cancers should not be affected, and hence, the diagnostic (pathology, imaging) and therapeutic services for hematological cancers were continued. In this study we analyzed the impact of the COVID-19 pandemic on diagnosis and treatment procedures and survival outcomes among patients with Diffuse Large B-Cell Lymphoma (DLBCL).ObjectiveTo compare treatment duration among patients with DLBCL during the COVID-19 period with those treated prior to the onset of the pandemic.DesignRetrospective record-based study.SettingRegional cancer center, JIPMER, India.Patients or Other ParticipantsThe medical records of treatment naïve DLBCL patients registered between January 2019 and December 2019 (Group 1; pre-pandemic) and January 2020 until December 2020 (Group 2: during pandemic) were accessed, and the following data were collected: baseline characteristics, time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients defaulting treatment.InterventionsNot applicable, as it is a retrospective record-based study.Main Outcome MeasuresPrimary endpoint was treatment duration during the COVID-19 period with those treated prior to the onset of the pandemic.ResultsA total of 67 patients were identified (Group 1: 46 (69%) Group 2: 21 (31%). The median age of patients registered in 2019 and 2020 were 50 (39–64) years and 44 (34–62) years, respectively. The duration between diagnosis to start of treatment for patients in 2019 and 2020 was 28 (13–43) days and 19 (11-40) days respectively. The duration between start of treatment to end of treatment for patients in 2019 and 2020 was 119 (107–137) days and 121 (101–145) days, respectively.ConclusionsThere was no significant difference in treatment duration among DLBCL patients during the COVID-19 pandemic. Treatment completion rates were similar.

Poster: ABCL-334: Impact of COVID-19 Pandemic on Treatment Duration in Curable Cancers: Comparison of Patients with DLBCL Treated Before and During: A Retrospective Record-Based Study

Poster: ABCL-334: Impact of COVID-19 Pandemic on Treatment Duration in Curable Cancers: Comparison of Patients with DLBCL Treated Before and During: A Retrospective Record-Based Study

Cervicofacial lymphatic malformations: diagnosis and management

BackgroundLymphatic malformations are rare benign tumors that result from congenital and acquired alterations of the lymphatic vessels. They occur most commonly on the head and neck region.The aim of this study is to describe clinical profiles of lymphatic malformations of the head and neck (LMHN) as well as to study therapeutic modalities through our series and review of the literature.ResultsThis is a retrospective record-based descriptive study conducted in the ENT and the Radiology departments over a 17-year period. Our study included twelve patients, aged between 8 months and 52 years. Two swellings were present at birth and had not been prenatally diagnosed in both cases. One patient was affected by TRISOMY 21.All patients consulted for a painless mass of the head or neck. Seven masses were located in the suprahyoid region and five in the infrahyoid region. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) were realized to establish the diagnosis and assess the extent of the lesions.Surgical excision was performed in 7 patients. It was complete in 6 patients. Five patients were treated with sclerotherapy. The sclerosing agents used were Aetoxisclerol 2%, hypertonic saline, and absolute alcohol. One patient had a reversible paresis of the left mental nerve after surgery. An excellent response to sclerotherapy with complete resolution was obtained in 3 cases with no recurrence of the disease.ConclusionsSurgical excision has been the management option of choice for LMHN. The recent advances in sclerotherapy make it safe and effective as a primary treatment modality for these lesions.

English

BACKGROUND Dacryocystitis is one of the most frequent diseases of the efferent lacrimal system. It is the infection or inflammation of the lacrimal sac. This is usually because of nasolacrimal duct obstruction. Acute dacryocystitis can cause severe morbidity and rarely mortality in patients. This study wanted to identify the aerobic bacterial aetiology, and demonstrate the antibiogram of bacterial isolates of acute dacryocystitis. METHODS A retrospective record-based study was conducted in Rural Tertiary Healthcare Centre. Clinical Data of 89 patients was collected from medical records of 2014 to 2018 documents. Data of bacterial isolates and their antibiogram were retrieved from records in the Department of Microbiology. RESULTS The most common aerobic Gram-positive bacteria were Staphylococcus aureus (29.8 %) and Coagulase Negative staphylococcus (23.3 %). The most common Gramnegative bacteria were pseudomonas spp. (19.4 %) and klebsiella spp. (12.9 %). CONCLUSIONS The knowledge of bacterial profile in different geographic region, different age group will help to develop and implement treatment protocol. KEY WORDS Acute Dacryocystitis, Bacterial Profile, Antibiogram

Psychological and clinical-epidemiological profile of poisoning in Nepal: an institutional experience

Background Poisoning has become a major public health problem, with the intent in most cases being self-harm and commit suicide. This study highlights the psychological and clinical-epidemiological profile of patients visiting Scheer Memorial Adventist Hospital after poisoning. Methods This retrospective record-based study was done among poisoning patients of a hospital in Nepal from 1st January 2018 to 31st December 2020. Data were analyzed using STATA version-15. Results Out of 134 total poisoning cases, 71 had consumed organophosphate compounds. The majority of the cases were female (59.2% in organophosphate groups, 69.8% in non-organophosphate groups). The circumstances of poisoning were mostly suicidal (95.8% in organophosphate groups, 90.5% in non-organophosphate groups) and the reasons for this being mostly family disputes. Organophosphate groups had 8.41 times higher odds of having complications when compared to non-organophosphorus compounds. Conclusions The majority of the poisoning cases were suicidal in nature and family disputes being the major reason for the intake of a poisonous substance. This demands that more attention be given to psychological and family counseling to resolve any disputes, as well as psychological management of poisoning cases after medical management. Also, a strong regulatory mechanism should be imposed to control the easy access to poisonous substances.

Psychological and clinical-epidemiological profile of poisoning in Nepal: an institutional experience.

Background Poisoning has become a major public health problem, withthe intent in most cases beingself-harm and commit suicide. This study highlights the psychological and clinical-epidemiological profile of patients visiting Scheer Memorial Adventist Hospital after poisoning. Methods This retrospective record-based study was done among poisoning patients of a hospital in Nepal from 1st January 2018 to 31st December 2020. Data were analyzed using STATA version-15. Results Out of 134 total poisoning cases, 71 had consumed organophosphate compounds.The majority ofthe cases were female (59.2% in organophosphate groups, 69.8% in non-organophosphate groups). The circumstances of poisoning were mostly suicidal (95.8% in organophosphate groups, 90.5% in non-organophosphate groups) and the reasons for thisbeing mostly family disputes. Organophosphate groups had 8.41 times higher odds of having complicationswhencompared tonon-organophosphorus compounds. Conclusions The majority ofthe poisoning cases were suicidal in nature and family disputes being the major reason for the intake of a poisonous substance. This demandsthat moreattentionbe givento psychological and family counseling to resolve any disputes, as well aspsychological management of poisoning cases after medical management. Also, a strong regulatory mechanism should be imposed to control the easy access to poisonous substances.

A Hospital based cross sectional study to find out factors associated with disease severity and length of hospital stay in COVID-19 patients in Tertiary Care Hospital of Ahmedabad city

Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without.

Correlation between pre-operative diagnosis and final pathological diagnosis of endometrial malignancies; impact on primary surgical treatment

Objectivesto compare the accuracy of preoperative and postoperative endometrial sampling obtained by dilatation and curettage (D&C), Pipelle and hysteroscopy to diagnose endometrial malignancies and to evaluate the adequacy of surgical treatment for these patients. Study designThis retrospective record-based study was conducted at Gynecology Oncology Unit, Ain Shams University Maternity Hospital, Cairo, Egypt. Records of patients with an initial preoperative or a final postoperative pathological diagnosis of endometrial hyperplasia or endometrial malignancies were retrieved over a six year period from January 2013 until March 2019. The preoperative biopsy methods, results, postoperative pathology diagnosis and treatment received were recorded and analyzed. ResultsRecords of 395 patients were retrieved. Rates of agreement between initial and postoperative pathology for endometrial hyperplasia (with and without atypia) were 10% by D&C, 7.8% by Pipelle and zero % by hysteroscopy; for endometrioid adenocarcinoma grade 1, they were 40.7% by D&C, 40.6% by Pipelle and 20% by hysteroscopy; for endometrioid adenocarcinoma grades 2 and 3, they were 83.7% and 84.6% by D&C, 97% and 60% by Pipelle, and 100% by hysteroscopy, respectively. For type II endometrial cancer and endometrial stromal sarcoma, agreement rates were 100% by all biopsy methods. Out of 13 cases diagnosed with atrophic endometrium preoperatively, 11 cases were diagnosed as endometrial stromal sarcoma. Comparing accuracy of the three biopsy methods, D&C had highest sensitivity of 61.9%; hysteroscopy showed 100% specificity, while Pipelle was the least accurate method. Finally, 61.4% of the patients received adequate surgical treatment. ConclusionThere were excellent concordance rates between initial biopsy and postoperative pathology in diagnosis of high grade endometrioid and other endometrial malignancies compared to endometrial hyperplasia and low grade endometrioid adenocarcinoma. Patients diagnosed initially with atrophic endometrium or hyperplasia warranted more surveillance before their surgical treatment. It is crucial to develop protocols for increasing accuracy of endometrial sampling such as performing molecular studies for preoperative pathology.

The incidence and clinical manifestations of human brucellosis in a referral hospital in Southern Saudi Arabia between 2015 and 2019.

We determined the incidence and clinical manifestations of human brucellosis from patients who attended a referral hospital in South of Saudi Arabia. A record-based retrospective study was conducted from January 2015 to December 2019 at King Abdulla Hospital, Bisha, Saudi Arabia. Information on patients' demographic characteristics, detailed records of signs and symptoms, and the laboratory findings were reviewed. Of 6,586 patients included, 15.8% (n = 1,041) were infected with brucellosis. The age of infected individuals ranged from five to 95 years, with an average of 35.1 ± 21.2 years. Most infected patients were male (72.3%). Young adults (26-44 years) were the most common age group with the disease (34.1%). The annual rate of infection significantly decreased (P < 0.0001) from 33.2% in 2015 to 12.5% in 2019. An escalating number of brucellosis cases was seen in the spring and peaked during the summer. Fever (35.3%), joint pain (25.5%), generalized body ache (10.7%), and neurological symptoms (10.0%) were the most frequent clinical manifestation associated with brucellosis. Joint pain was commonly found among children (44.4%). Neurological findings were more frequent among adult patients. The study concluded that brucellosis is endemic in Southern Saudi Arabia and needs local health authority to implement preventive and educational program measures. Infected patients may present with diverse, nonspecific clinical manifestations that require intuition from clinicians to detect the disease.

Symptoms presentation and aggressiveness pattern of prostate cancer in a Moroccan population

Around the world, prostate cancer is one of the leading types of cancer in men. Indeed, according to the most recent reports, approximately 1.27 (7.1%) million new cases were diagnosed with an estimated 358,989 (3.8%) deaths. Prostate cancer manifests in a varied incidence according to the ethnic-geographic origin of patients. In Morocco, it is a public health issue regarding its frequency and severity, being the second most common male cancer with 3990 (15.8%) new cases recorded in 2018. This work aims at depicting the pattern of prostate cancer presentation in the Moroccan population for the first time, in regard to some clinical and pathological features along with aggressiveness nature in patients followed up in Mohammed V military hospital of Rabat which is a referral center. In this retrospective record-based study, the epidemiological, clinical, and histo-biological characteristics of 104 prostate cancer cases, at the time of diagnosis were assessed, such as age, prostate-specific antigen (PSA) level, Gleason grade, symptomatic pattern. Data analysis was done by the software SPSS version 23 using the statistical test two-tailed Pearson Qui-square test and two-tailed independent t-test. The results show that the mean age at diagnosis is 68 years. The mean PSA level, prostate volume and PSAd (PSA density) levels were 70.08 ng/ml, 61 grams and 1.66 ng/ml/gm respectively. Half of the patients had a PSA level of less than 10 ng/ml and only 21.2% were accidentally discovered during systematic screening. Symptomatic patients were significantly associated with age ( P = 0.04) and with digital rectal examination (DRE) suspicion ( P = 0.03) at diagnosis. Our reports confirm that Moroccan men with prostate cancer have higher PSA, PSA density and aggressive Gleason grade at diagnosis and that symptoms presentation increase along with age and are significantly related to the abnormality of DRE.

Profile of allergic rhinitis patients in a tertiary care centre in Central Kerala

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Allergic rhinitis (AR) is a major public health problem which has a significant impact on the quality of life. Around 20-30% of the Indian population suffers from AR. The objective was to study the clinical profile and find out the factors associated with severity.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This retrospective record-based study was conducted among 182 patients with AR who visited Department of otorhinolaryngology in a tertiary care hospital in central Kerala. Variables collected included age, gender, family history of allergy, duration of disease and details of symptoms. The visual analogue scale (VAS) was used in identifying the severity of symptoms.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean age of participants was 39±19 years. Nearly 50% of them had positive family history and 77.5% were found to have severe symptoms. The mean total VAS score was 25±5.1. Sneezing and nasal block were the common symptoms reported. Among the participants who had family history, 77 (87.5%) of them reported severe symptoms (χ&lt;sup&gt;2&lt;/sup&gt;=9.81, p=0.002). Almost all participants belonged to higher age group reported high severity (χ&lt;sup&gt;2&lt;/sup&gt;=48.130, p&amp;lt;0.0001). More than 80% of the participants who reported a longer duration of disease had severe symptoms (χ&lt;sup&gt;2&lt;/sup&gt;=7.28, p=0.007).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The study identified a significant proportion of sneezers and blockers among the study population. Older age group, family history and longer duration of disease were the factors associated with severity. Generating community awareness will help in early diagnosis, effective control with improvement in quality of life of these patients.&lt;/p&gt;

Antibiograms of intensive care units at an Egyptian tertiary care hospital

BackgroundIntensive care unit (ICU) infection management is a growing challenge, and physicians should have regularly updated antibiograms. The aim of this study was to find out the prevalence of pathogens and to determine their antibiotic susceptibility in different ICUs of an Egyptian tertiary care hospital. This retrospective record-based cross-sectional study was conducted from the first of January to the last of December 2019 with a total of 45,221 diagnostic first-isolate culture/patient obtained from different ICUs in Zagazig University Hospitals. The antibiogram construction was done according to Clinical and Laboratory Standards Institute instructions and a Web-based antibiogram at Stanford University.ResultsThe positive blood isolate was the most prevalent infection site (32.37%) followed by sputum and urine isolates. Gram-negative microorganisms (74.41%) were the most common pathogens, with Klebsiella pneumoniae as the most frequently identified one with an incidence of 33.51% followed by Escherichia coli with 19.3% incidence. Antibiotic sensitivity showed that colistin is the most effective antibiotic with 96.2%, 94.7%, and 89.9% sensitivity for Klebsiella, E. coli, and Acinetobacter, respectively, while carbepenems sensitivity was extremely low, showing 19.5% and 19% imipenem and meropenem sensitivity for Klebsiella, 48% imipenem and 52.7% meropenem sensitivity for E. coli, 20.1% imipenem and 20.3% meropenem sensitivity for Acinetobacter, and 17.3% imipenem and 15.2% meropenem sensitivity for Pseudomonas aeruginosa. Fungal infection in our results represented less than 1%.ConclusionOur study provides a local baseline epidemiological data which describes the extent of the ICU infections problem in this tertiary care hospital.Trial registrationClinicalTrials.gov (NCT04318613)

A comparative evaluation of the effects of ZLN and TLE anti-retroviral regimens in HIV positive patients: A retrospective record-based study

Objectives: Until 2012, zidovudine+lamivudine+nevirapine (ZLN) was the first line treatment for human immunodeficiency virus (HIV)-positive patients, whereas in 2013, tenofovir+lamivudine+efavirenz (TLE) was recommended as a preferred regimen due to less adverse drug reactions and better virological response. The present study was done to compare the change in CD4 count and emergence of opportunistic infections (OIs) in HIV-positive patients on ZLN and TLE regimens. Materials and Methods: This retrospective record-based study was conducted at anti-retroviral therapy (ART) center of a tertiary care hospital on 150 charts of patients on ZLN (Group A) and TLE (Group B) regimens each for 1 year. Data were analyzed using GraphPad Prism version 6. Results: The mean age of patients in Group A was 38.72 (±10.5) years and Group B 37.75 (±11.57) years (P = 0.4460). After 1 year of ART, the mean CD4 count (cells/mm3) increased in both groups (Group A: 223.51 [±111.21] to 415.37 [±218.16] [P = 0.0001] vs. Group B: 255.05 [±164.50] to 433.12 [±247.66] [P = 0.0001]). With the baseline counts being comparable (P = 0.0527), the difference in mean CD4 counts between the groups post-ART was not statistically significant (P = 0.5105). The incidence of OI was 45% in Group A as compared to 25% in Group B. Overall, the most prevalent OI was tuberculosis (TB) (13.33%). Conclusion: Both ZLN and TLE regimens are equally effective in improving the immunological status of HIV-positive patients. Patients on ZLN have higher incidence of OI than those on TLE. However, therapy should be individualized as per patient’s suitability.

Pain Medication Administered and Prescribed to Patients With an Ankle Sprain Treated in an Emergency Department: A Record-Based Cohort Study

IntroductionRecent data indicate that patients treated in the emergency department for an ankle sprain receive multiple medications. However, research has not been able to accurately identify all the medications because of study limitations. The primary purpose of this study was to document the type of medication, number of doses, and number of encounters given a prescription at discharge or instructions to take over-the-counter medication. The secondary purpose was to determine if the proportion of encounters given each type of medication varied on the basis of age, sex, race, and year. MethodsA retrospective record-based cohort study design was used to review the electronic medical records (N = 1740) of encounters reporting to a southeast academic level 1 trauma center and diagnosed with an ankle sprain between 2013 and 2017. All relevant data were extracted for nonsteroidal anti-inflammatory drugs, muscle relaxants, opioids, and nonopioid analgesics. ResultsFifty-eight percent of the encounters had at least 1 dose of medication administered in the emergency department. Twenty-eight percent received a prescription at discharge, and 54.5% were instructed to take over-the-counter medication. Cumulatively, opioids accounted for most of the medications, but the yearly rates declined from 2013 to 2017. A greater proportion of patients aged ≤15 years received nonsteroidal anti-inflammatory drugs or nonopioid analgesics. Most of the patients aged >15 years received opioid medication. DiscussionPatients are primarily given an opioid or nonsteroidal anti-inflammatory drug in the emergency department. Fewer patients receive a prescription at discharge but are regularly instructed to take over-the-counter medication.

Prevalence of High Risk Pregnancy: in A Tertiary Care Centre of Sagar Division of M.P.

Background: High risk pregnancy is broadly defined as one in which mother, fetus or newborn is or will beat increased risk for morbidity or mortality before or after delivery. According to WHO, globally about 830women die from pregnancy or childbirth-related complications every day. About 20-30% of all pregnanciesbelong to high-risk category, which is responsible for 70–80% of perinatal mortality and morbidity.Hence, the current study was done to determine the prevalence of high-risk pregnancies and associated highrisk factors among antenatal women in a tertiary care centre of central India.Aims &amp; Objectives: To know the prevalence of high-risk pregnancies and associated high risk factors.Materials and methods: Ethics approval to conduct the study was obtained from the Institutional EthicsCommittee. It is a record-based retrospective longitudinal study done among 3898 antenatal women whohave attended/ referred to our tertiary care institute, Bundelkhand Medical College, Sagar, M.P. duringFebruary 2020 to May 2020.High-risk pregnancy was classified based on the guidelines from the Pradhan Mantri Surakshit MatritvaAbhiyan.Results: Among 3898 antenatal case record reviewed. Results of this study show that the prevalence ofhigh-risk pregnancy among study participants was 16.54%.Most of the pregnant women were in age group of 20-35 years that is 94.72%.Most of the pregnant women were multigravida 57.20% by gestation.Regarding obstetric and neonatal outcomes, majority had normal vaginal delivery (60.6%). The mostcommon high risk factors were history of previous cesarean section 31.94 %, Hypertension in Pregnancy22.17% &amp; Abnormal Presentation were 13.95%.Conclusion: The current study found that almost one-sixth (16.54%) of the pregnant women have highriskpregnancy. Hence, early detection of high-risk pregnancy needs to be done to improve the maternal,obstetric, and neonatal outcomes.

Medico Legal Documentation in a Public Hospital in India: An Analysis of 100 Cases

Introduction: Medico-legal audits are an integral part of hospital/clinical audits and involve examinationof the hospitalrecords. The clinical audits aim towards improvement of quality of care and hence are limitedto the scrutiny of patient’s clinicalrecords. On the other hand, a medico-legal audit aims at the prevention offoreseeable litigations on the hospital and includes the perusal of all the hospital records.Aim & Objective: To carry out the audit of medico legal documentation in a public hospital.Methodology: A retrospective record-based study was conducted in a 2000 bedded public hospital inthe month of May-June 2012. 100 documented medico legal cases were considered using simple randomsampling. The quantitative data was collected by using a checklist for the audit of medico legal case files.SPSS was used for the analysis of the data.Results: Most of the MLC cases were found to fall in the middle age group of 21-35 years of age (32%)and within that the maximum people contributing to the MLC cases was the sub- group of age between 21-25 years (16.66%). Out of the total recorded sex of the MLC cases, 65.96% were males and 34.04% werefemales. The highest number of cases recorded were of the RTA (20%) followed by the accidental injury(17%).Discussion & Conclusion: Alarge number of the cases were of the road traffic accidents (20%)followed byaccidental injury (17%), so the emergency department should be kept well equipped to treat such cases. Theproportion of the male patients (65.96%)was double as compared to the female patients (34.04%), so thehuman resource planning of the emergency department can be done accordingly.

Pattern of injuries sustained during training: A retrospective record-based study

Background: Physical injuries constitute a major health problem in the training institutes. The present study was undertaken with the aim to analyze the injury pattern in a training institute. Materials and Methods: This study was carried out on male trainees of a premier training academy. Trainees with all forms of injuries were included in the study. This was a descriptive record-based study carried out at a tertiary-level hospital. The records were extracted from January 2011 to December 2016. These trainees were assessed in terms of their age, term, activity causing the injury, anatomical part injured, and their final disposal. Results: Out of a total of 5400 trainees, 1536 trainees with various forms of injuries were assessed (28.4%; 95% confidence interval [CI]: 27.2–29.7). Their mean age was 18.62 years (standard deviation: 0.9 years). The lower limbs were most commonly injured (n = 1167, 75.91%; 95% CI: 73.7%–78.0%). There were 865 (56.3%) cases of soft-tissue injuries in comparison to 671 (43.69%) cases of bony injuries. Injuries due to physical training outnumbered to those sustained during sporting activities. Majority of the cases were managed conservatively (n = 1445, 94.07%), and only 85 trainees required surgical intervention (5.53%). Loss of man-days ranged from 1 to 309 days (mean: 38.18 days). Conclusion: Injuries are an integral part of training, resulting in morbidity and loss of man-days. The descriptive epidemiology of the injuries may help in formulating preventive and promotive measures for injuries.