Tertiary Health Facility Research Articles

The patterns of presentation, management and outcomes of breast cancer patients at a tertiary health facility in Sierra Leone

BackgroundBreast cancer is the leading cause of cancer among women globally and the most common cancer among women in Sierra Leone. This study aimed to evaluate the patterns of clinical presentation, management and outcomes among breast cancer patients who presented at the Connaught Teaching Hospital Complex in Sierra Leone.MethodA retrospective, cross-sectional study was conducted at the specialist outpatient clinic at the Connaught Hospital. The medical records of 253 breast cancer patients were selected through convenience sampling on the basis of the completeness of their data from 2018 to 2021. The patients’ sociodemographics, obstetrics-gynecological history, clinicopathological characteristics, treatment modalities, and outcomes were analysed via SPSS version 24.ResultsAmong the 253 patients with breast cancer, 246 (97.2%) were female, and the mean age of the patients was 47 ± 14 years. The mean age at menarche was 12 ± 3 years, and 35 (13.8%) patients had a family history of breast cancer. The left breast of 130 (51.2%) patients was the most commonly affected; approximately 119 (47%) patients presented with stage III B disease, and 35 (13.8%) presented with metastasis. With respect to treatment modalities, surgery, chemotherapy, and hormonal therapy were provided to patients — with 120 (48%) mastectomies, 73 (29.2%) neoadjuvant chemotherapy, 84 (33.6%) adjuvant chemotherapy, 98 (39.2%) hormonal therapy, 35 (14.0%) palliative care and approximately 38 (15.2%) refused or did not initiate any treatment. Among the outcomes of breast cancer patients, 19 (32.8%) was the highest mortality rate in 2019, and 10 (27.8%) was the lowest in 2018.ConclusionOur study revealed that over half of our breast cancer patients presented with advanced-stage disease, and mastectomy was the most common modality of treatment. Further studies are needed to understand the factors responsible for their late presentation and improve histological services and access to radiotherapy facilities for our patients.

Epidemiology and clinicopathological features of soft tissue tumors in adolescents: a cross-sectional study

BackgroundSoft tissue tumors (STTs) in adolescents are relatively rare, and their characteristics and behavior have not been well studied in this age group. The aim of this study was to describe the clinicopathologic patterns of STTs in adolescents aged 10–19 years according to the 2020 WHO classification.MethodA 10-year retrospective cross-sectional study of 632 surgical samples from adolescents was conducted at a tertiary health facility to determine the frequency, histological patterns and characteristics of STTs in this population. The data were analyzed via SPSS 23.ResultsSTTs accounted for 12.5% of all histologically diagnosed lesions in adolescents, with a mean age of 15 ± 2.9 years, 54.4% occurring in females and 35.4% in middle adolescents. The majority (64.56%) of STTs were benign, while malignant and intermediate-grade neoplasms accounted for 25.32% and 10.13%, respectively. Vascular tumours were the most common, followed by adipocytic and fibroblastic/myofibroblastic tumours, with hemangiomas being the most common. The most prevalent symptom was a painless mass (82.3%), with the head and neck (25.3%) being the most commonly involved body site. Most of the STTs patients presented within the first two years of occurrence (36.7%, n = 29/79). However, age, age group and sex were not significantly associated with the WHO grades of these STTs.ConclusionThis study provided valuable insights into the characteristics and behavior of STTs in adolescents, highlighting the importance of early diagnosis and management. These findings suggest that adolescent STTs affect females more than males , involve the head and neck more and are more benign, with vascular tumours being the most common type of STT in this age group.

Association Between Severity of Age‐Related Hearing Loss and Co‐Morbidities: An Institution ‐Based Study in a Sub‐Himalayan Tertiary Healthcare Facility of North Bengal

Association Between Severity of Age‐Related Hearing Loss and Co‐Morbidities: An Institution ‐Based Study in a Sub‐Himalayan Tertiary Healthcare Facility of North Bengal

"If my husband was in the labor ward with me, my baby wouldn't have died"; experiences on birth companionship from a tertiary health facility, Tanzania.

Despite existing policies promoting companionship, it remains uncommon in Tanzania. Pregnant women select a trusted individual to accompany them during childbirth, providing emotional, physical, and spiritual support. The World Health Organization recommends birth companionship as integral to intrapartum care for positive maternal and fetal outcomes. This study aimed to explore the experiences of pregnant women and healthcare providers regarding childbirth companionship at a tertiary health facility in Tanzania. Participants were purposefully selected for qualitative exploratory interviews. Focused group discussions were conducted with pregnant women attending antenatal clinics, and in-depth interviews were held with healthcare providers at Mbeya Zonal Referral Hospital in Tanzania. Braun and Clarke's six-step thematic analysis approach was used to analyze the data. Three major themes emerged: "Bonding and Learning with Spouse/Partner," "Assurance of Maternal Safety," and "Fear of Blame and Breach of Confidentiality." These themes highlight a strong desire among both pregnant women and healthcare providers for companionship during labor, particularly from male partners. Emotional support and safety were cited as key reasons. Fear, however, was identified as a major obstacle, with providers concerned about potential exposure of mistakes and pregnant women fearing a violation of their privacy rights regarding health matters. Pregnant women expressed a strong desire for companionship throughout labor. However, companionship faced challenges due to staff shortages and inadequate privacy in labor wards. There is a pressing need to enhance childbirth companionship practices and policies in low-resource settings.

Control to Target of Cardiometabolic Risk Factors among Type 2 Diabetic Out-Patients: An Experience from A Tertiary Health Facility in South-Eastern Nigeria

Control to Target of Cardiometabolic Risk Factors among Type 2 Diabetic Out-Patients: An Experience from A Tertiary Health Facility in South-Eastern Nigeria

Financial and Emotional Burden of Caregiving on Informal Caregivers of Geriatric Patients at a Tertiary Healthcare Facility in Ibadan, Nigeria

Financial and Emotional Burden of Caregiving on Informal Caregivers of Geriatric Patients at a Tertiary Healthcare Facility in Ibadan, Nigeria

Concurrent acute myocardial infarction and acute ischemic stroke in a diabetic patient undergoing chemotherapy for non-Hodgkin lymphoma: Should I administer thrombolytic therapy? A case report.

Concurrent ST-elevation myocardial infarction (STEMI) and acute ischemic stroke (AIS) are extremely rare, and their management remains perplexing due to the absence of high-quality evidence and limited resources. For the first time, we report a rare, preventable, and suboptimally managed case of concurrent AIS and STEMI in a patient with non-Hodgkin lymphoma (NHL) who received cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy. A 59-year-old postmenopausal woman of African origin with a background history of type 2 diabetes mellitus presented to the Jakaya Kikwete Cardiac Institute with sudden onset of left-sided weakness and typical ischemic chest pain for 3days. The patient was recently diagnosed with NHL and started CHOP chemotherapy 3weeks prior. Physical examination revealed left-sided hemiplegia. Emergency brain computed tomography and 12-lead echocardiography (ECG) revealed AIS and STEMI, respectively. A diagnosis of concurrent AIS and STEMI was reached, and the patient was loaded with dual antiplatelets and heparin and rushed for emergency coronary angiography (GAG) and percutaneous coronary intervention (PCI). CAG revealed massive thrombotic occlusion of the mid-segment of the left anterior descending coronary artery (mLAD) and proximal segment of the right coronary artery. Revascularization was achieved in both vessels with a resultant TIMI flow grade of 3. The post-PCI period was marked by significant improvement in chest pain and resolution of ST-elevation, as revealed by 12-lead ECG. However, the patient remained hemiplegic. We have described a rare case of concurrent AIS and STEMI in a postmenopausal woman who had a significant risk of thromboembolism. The patient had uncontrolled type 2 diabetes and received CHOP chemotherapy for NHL, which was diagnosed 3weeks prior. This case underscores the need for thromboembolic prophylaxis for selected cancer patients receiving chemotherapy. The need to individualize management is also emphasized, as both PCI and thrombolysis carry the risk of serious repercussions. In our patient, if thrombolysis was attempted it would have caused myocardial rupture and immediate death. The patient would have benefited from endovascular mechanical embolectomy for AIS; however, this practice is lacking at our institution. This calls for the establishment and strengthening of neurointerventional practices in our tertiary healthcare facilities.

Maternal Mortality in Tertiary Health Facilities in Edo State, Southern Nigeria

Nigeria ranks high in maternal mortality among developing countries despite the effort to reduce it. This paper is based on a ten-year study from 2008 to 2017 on maternal mortality from two public healthcare facilities in Edo State that have the most referrals. A facility-based survey design was used to determine the maternal mortality ratio, level of obstetric utilisation (booked and un-booked patients), number of caesarean sections, and causes of maternal deaths. Information on maternal deaths was collected from the University of Benin Teaching Hospital and the Central Hospital. The number of maternal deaths was 350 with 54,124 live births; and the Maternal Mortality Ratio (MMR) was 674 per 100,000 live births during this ten-year review. The findings show an increase of 11,780 caesarean sections among pregnant women during the delivery period. The major direct causes of maternal death were eclampsia and haemorrhage, while the indirect causes were HIV/AIDS, and other complications. The high number of pregnant women with no antenatal registration (un-booked) in these facilities depicts delays in receiving effective maternal healthcare services. The need arises for early registration and basic/comprehensive emergency obstetric care (EMOC) at all tiers of health facilities, which will decrease the risk of mortality and morbidity. The study recommends that to prevent delays in offering maternal healthcare services, there should be effective EMOCs at all healthcare facilities, and there is a need to encourage early antenatal registration that could reduce caesarean sections at health facilities for most pregnant women.

Impact of rotational shiftwork related sleep deprivation on quality of life and job satisfaction among healthcare professionals in Southern India from the SNORE study findings

Abstract Background Sleep is essential for cognitive function and overall well-being, yet healthcare providers often experience sleep deprivation due to long hours and night shifts. This study evaluates how sleep deprivation affects Quality of Life (QoL) and job satisfaction among these workers. Methods We conducted a cross-sectional study at a tertiary healthcare facility in Chengalpattu District, Tamil Nadu, India, including 293 healthcare providers working rotational night shifts. Participants were selected through stratified random sampling. QoL was assessed using the Short Form-12 QoL Questionnaire (SF-12). Sleepiness was assessed using Epworth Sleepiness Scale (EPSS). Statistical analyses included Pearson chi-square tests for associations, independent samples t-tests for comparing QoL scores between sleep-deprived and non-sleep-deprived participants, and binary logistic regression to evaluate the impact of sociodemographic factors and shift work patterns on SF-12 scores. Results Significant associations were observed between sociodemographic factors, shift work patterns, and SF-12 QoL scores. Married participants had nearly four times higher odds (OR = 3.97, 95%CI 1.87–8.43) of scoring < 40. Diploma holders had nearly three times higher odds (OR = 2.94, 95%CI 1.48–5.83) compared to graduates. Paramedical professionals had over three times higher odds (OR = 3.48, 95%CI 1.55–7.82) compared to doctors. Sleep deprivation was associated with lower PCS (aOR = 2.45, 95%CI 1.40–4.27) and MCS scores (aOR = 3.80, 95%CI 1.56–9.23). Increased night work hours correlated with higher odds of poor work satisfaction (OR = 1.39, 95%CI 1.18–1.63). Conclusion Sleep deprivation significantly impacts physical and mental QoL scores among healthcare providers working rotational night shifts. Current shift work patterns also affect QoL, highlighting the need for targeted interventions to improve sleep and manage shift work.

An Echocardiographic Study of a Rare Cause of Mitral Regurgitation: Hypoplastic Posterior Mitral Valve Leaflet.

The precise etiology of hypoplasia of the posterior mitral valve leaflet (PMVL) remains incompletely elucidated; however, it has been hypothesized to stem from genetic mutations occurring during fetal development. Herein, we present the anatomical characteristics of the mitral valve and associated cardiac pathologies in patients with hypoplastic PMVL. This single-center retrospective study involved patients who presented between 2015 and 2021 at a tertiary healthcare facility. Among the cohort, 44 individuals had hypoplastic PMVL and were divided into 2 groups: those with severe mitral regurgitation (MR) and those with non-severe MR. Among the patients, 11 (25%) had severe MR. The median lengths for the PMVL was 5 mm (5-6). Moreover, 10 patients had concomitant muscular formation. We found that 13 patients had bicuspid aortic valve (BAV), while the second most common concomitant cardiac congenital pathology was secundum atrial septal defect (ASD) in 7 patients. The anterior mitral leaflet (AML) length (P = .007), AML prolapse (P < .001), and A2P2 distance (P = .008) were higher in the group with severe MR. In addition, muscular formation was more common in patients with hypoplastic PMVL with severe MR (P < .001). Hypoplastic PMVL is a rare but significant anomaly that causes MR. While it can coexist with numerous congenital conditions, the most frequent associations include BAV and, secondly, ASD. Severe MR is particularly observed in cases accompanied by dilated mitral annulus, AML prolapse, and muscular formation.

Factors Influencing the Gestational Age at Initiation of Antenatal Care in A Tertiary Health Facility in South-South,Nigeria

Factors Influencing the Gestational Age at Initiation of Antenatal Care in A Tertiary Health Facility in South-South,Nigeria

Biochemical Analysis of Cerebrospinal Fluid in Paediatric Patients: Insights from a Tertiary Hospital in Nigeria

Aim: Cerebrospinal fluid analysis is an investigation routinely carried out in patients to make a diagnosis, exclude a diagnosis or treat infectious and non -infectious diseases of the nervous system. Analysis of cerebrospinal fluid could be biochemical, microbiological or hematological. The aim of the study was to review the characteristics of biochemical analysis of cerebrospinal fluid requests over a one-year period (January to December 2023) in a tertiary health facility. Study Design: This was a retrospective descriptive study of the biochemical analysis of 106 cerebrospinal fluid (CSF) samples over a one-year period in a tertiary health facility. Methodology: Data on the age, sex, diagnosis of the patients and the results of the biochemical analysis of the CSF were analysed using the SPSS 24 and results presented as descriptive data. Results: A total of 106 CSF specimen were analysed with only two specimen from adults. Most of the specimen were from males (male to female ratio is 2.25:1) while the most common diagnoses for requesting for CSF analysis were meningitis, sepsis and febrile convulsion. Most specimen were sent between the months of October (9%), December (13%) and January to March (37%). The total number of CSF glucose results that were low when compared to the plasma glucose was 45 which is 42.3%. A little lower than a fifth 21 which is 19.8% had increased protein levels. Conclusion: The CSF biochemistry request pattern showed that most of the specimen were from the paediatrics department, with a higher male preponderance, the three main working diagnoses were, meningitis, sepsis and febrile convulsions. 42.3% of the specimen had reduced glucose levels, while 19.8% had increased protein levels. Improperly filled forms constituted a limitation to the study.

Role of Indian Association of Preventive and Social Medicine in Community Based Palliative Care - A Position Statement

Currently, access to palliative care is a challenge for the majority of people with serious health suffering in India. Most of the existing palliative care services are available at tertiary healthcare facilities in urban areas. The National Program of Palliative Care (NPPC) envisages incorporating palliative care in undergraduate medical education to improve the knowledge and skills of primary care physicians to provide quality palliative care in the home setting of patients. Additionally, NPPC also aims to promote community awareness and ownership in palliative care. Community-based palliative care (CBPC) provides holistic support for patients with serious illnesses. This position statement intends to address possible considerations on the role of the Indian Association of Preventive and Social Medicine (IAPSM) on CBPC in the country. A team of members of IAPSM trained in essential palliative care attempted to develop this position statement. The team explored the existing status of palliative care in India and feasible solutions through IAPSM for CBPC by the objectives of NPPC. The team applied and analyzed the WHO framework of public health approach to palliative care – amalgamation in primary health care, integration with specialists for continuum of care, public awareness, training of primary care physicians and community volunteers, and supportive supervision in community initiatives. IAPSM can effectively contribute to CBPC through capacity building of the primary health care team, awareness generation, promoting community ownership, and development of standards of care through community-based research. Implementing the aforementioned recommendations would contribute to achieving the target of Sustainable Development Goal 3.8, which addresses the need for pain relief and palliative care to all needy patients. The IAPSM recognizes palliative care as a vital component of Universal Health Coverage and holds the capacity to bring about substantial changes in the promotion of CBPC in India.

Risk Factors of Intrauterine Fetal Death in Cipto Mangunkusumo General Hospital, Indonesia

Intra Uterine Fetal Death ( IUFD ) results from various disorders of the mother, fetus, and placenta. This study aimed to explore factors contributing to IUFD, knowing the risk factors will prevent this case in the future time. In 2016-2018, patients diagnosed with IUFD at 22 weeks of gestation were included. One hundred twenty-five patients with IUFD and 125 controls with alive fetuses were enrolled. Data were collected from the medical records of participants. Factors that may have contributed to IUFD were explored. Comparisons between various risk factors and outcomes of the two groups were made. P-value was statistically significant if ≤0.05. We found several factors that contribute to IUFD. Some factors like BMI, ANC provider, referred from tertiary health facility, and congenital anomaly increased the risk of IUFD by 2.86, 5.86, 6.26 and 9.45 times respectively. In contrast, some factors like a number of ANC ≥ 6 times and gestational age &gt;36 weeks decrease the risk of IUFD. Regular and intensive ANC ≥ 6 times during pregnancy, number of pregnancy and gestational age ≥ 36 weeks significantly decreases the risk of IUFD with OR 0.12, 0.4, and 0.23 respectively. High-quality ANC to identify IUFD risk factors may lead to a significant decrease in its occurrences. Some factors like BMI, ANC provider, referred from tertiary health facility, and congenital anomaly increased the risk of IUFD, but Number of ANC≥ 6 times, number of pregnancy ≥2 and gestational age ≥36 weeks can reduce risk of IUFD.

Prevalence and determinants of TB/HIV coinfection: the double tragedy of infectious disease burden – a 5-year retrospective study in a tertiary health facility in Enugu State, Nigeria

ObjectiveTo ascertain the prevalence and determinants of tuberculosis (TB)/HIV coinfection in Enugu State Nigeria.Study designA 5-year record-based retrospective study (2018–2022) conducted at a tertiary health facility to identify TB/HIV coinfections.SettingAbout...

Triage processes in primary, secondary, and tertiary health care facilities in the Kathmandu Valley, Nepal: a mixed-methods study

BackgroundIn healthcare facilities, an efficient triage system is critical to optimize patient care. The main objective of this study was to explore the triage processes and practices in three different tiers of healthcare facilities in the Kathmandu Valley, Nepal.MethodsA mixed-methods approach in this study comprised observations and interviews in ten healthcare settings across primary care centers (PHC; n = 6), secondary care centers (SHC; n = 3), and tertiary care hospital (n = 1). Data were collected from June to November 2023. Semi-structured interviews were conducted among patients (n = 30) including survey questionnaires among 144 healthcare workers (HCWs) focused on triage. The qualitative data were analyzed using Interpretative Phenomenological Analysis and quantitative data were analyzed to explore the median score on the consistent practice of triage based on the Likert scale.ResultsPHCs had designated space for triage with less equipped emergency services and outpatient departments (OPDs) and received severely ill patients rarely. Although prioritizing critical patients and prompt care was part of the services, there was a lack of triage protocols with more than half of the HCWs (56.3%; 36/64) from the tertiary hospital reporting the availability of triage guidelines compared to SHCs (28.1%; 9/32) and PHCs (6.3%; 3/48). The majority of HCWs from the tertiary level recognized triage's effectiveness in reducing time lag, and prioritizing patients. Tertiary level had the consistent use of triage (94%; 60/64) compared to only around two-thirds in SHCs (66%; 19/29) and PHCs (62%; 28/45). Patients often attended PHC services for routine check-ups and were motivated by health insurance, affordability, free medicines, referral cards, and proximity. In the SHC, there was a well-equipped emergency department (ED) with specific guidelines, but its use was infrequent. Patients were unaware of the triage process and its utility. In all settings, while most HCWs had a basic knowledge of triage, some were not confident due to limited exposure to the triage process and training. Many HCWs reported the need for triage-related training and its’ consistent implementation.ConclusionsConsistent utilization of triage protocols, coupled with improved infrastructure, resource allocation, and training for healthcare workers is critical for the optimization of triage processes in healthcare settings in the Kathmandu Valley, Nepal.

Perceived work-related stress and associated factors among the surgical workforce in a Nigerian tertiary health facility: A cross-sectional study.

Healthcare workers continue to experience high levels of work-related stress which continue to negatively affect their psychological, physical, and emotional well-being. This is even more prevalent among healthcare workers who work in surgical specialities, with the surgical operation room becoming a known stressor at hospitals. This study aims to assess work-related stress among surgical team members at Ahmadu Bello University Teaching Hospital in Zaria between January 2021-2022. Data analysis involved descriptive and inferential statistical approaches using the Statistical Package for Social Science (SPSS) version 23.0. The study found an overall high prevalence of work-related stress, with 65% of participants reporting moderate levels of stress. The majority of the participants have a mean age of 39.4 ± 7.8 years, most of them being physicians (66.3%), being males (59.9%), and identified with a Hausa ethnic tribe. Notably, the multiple regression analysis found that tribe (p = 0.008), professional cadres (p = 0.001) and age/years of experience (p = 0.0035) emerged as significant predictors of work-related stress. Key determinants of work-related stress among surgical team members include workload, complexity of work, and conflicting cognitive job demands that continue to subject professionals to increasing workloads and constant decision-making about their job. Organizational factors, such as job policy and procedure, communication problems, and the nature of facilities, were identified as the highest contributors to work-related stress in organizational, interpersonal, and physical/environmental dimensions. The findings lead to the conclusion that a considerable proportion of surgical team members experience a relatively high level of work-related stress, primarily attributed to workload and cognitive demands. In light of these results, urgent efforts are recommended to improve the working conditions and environment for surgical team members. Furthermore, the integration of stress management measures into the educational programs for the surgical team is emphasized to effectively address and mitigate the impact of work-related stress.

The Nurse Managers’ Knowledge and Attitudes Toward Transformational Leadership Styles in Ondo State, Nigeria

This study investigates the knowledge and attitudes of nurse managers regarding transformational leadership (TL) style in Ondo State, Nigeria. Specifically, it aims to describe the knowledge of top nurse managers about TL and explore their attitudes towards its four components: idealised influence, inspirational motivation, intellectual stimulation, and individualised consideration. Employing an explorative qualitative approach, the study involved in-depth interviews with 12 nurse managers selected through purposive sampling from primary, secondary, and tertiary health facilities. The interview guide was adapted from the Multifactor Leadership Questionnaire (MLQ), featuring open-ended questions to elicit detailed responses. Data were analysed using thematic analysis with Atlas Ti 9 software. Findings revealed that while participants demonstrated a basic understanding of leadership, their knowledge of TL style was superficial, often conflating it with democratic leadership. Their attitudes towards the TL components were similarly limited. For example, participants emphasised teamwork and delegation under idealised influence but lacked deeper application of ethical and visionary attributes. Inspirational motivation, intellectual stimulation, and individualised consideration were inconsistently implemented, with respondents displaying only partial understanding of these concepts. The study highlights the need for comprehensive training to enhance nurse managers’ understanding and practice of TL style. Such training could improve nursing leadership, foster positive organisational culture, and ensure quality patient care. Recommendations include the development and implementation of TL-focused training programmes for nurse managers across health institutions in Ondo State.

Insights into fetomaternal outcomes in pre-eclampsia: A tertiary care center descriptive study

Preeclampsia and eclampsia remain significant challenges in both maternal and perinatal health worldwide, with a pronounced impact in regions such as India, where access to comprehensive maternal care can be limited. The objective of this study was to examine the outcomes for both mothers and babies, along with the complications linked to severe cases of preeclampsia and eclampsia, within a tertiary healthcare facility situated in South India. : Sixty-five pregnant women diagnosed with severe preeclampsia or eclampsia were enrolled in this descriptive observational study conducted at a tertiary care teaching hospital, Chennai, spanning from March 2023 to December 2023. Inclusion criteria comprised women with singleton pregnancies exhibiting severe preeclampsia (defined by blood pressure ≥160/110 mmHg and 1+ or more albuminuria) or eclampsia. Exclusion criteria included chronic hypertension, multiple pregnancies, chronic renal disease, connective tissue disorder, neurological complications, and refusal of consent. Data on sociodemographic variables, obstetric characteristics, maternal symptoms, and complications were collected using a structured questionnaire. Maternal and fetal well-being were assessed through biochemical, radiological, and nonstress tests.: The results revealed that 80% of the study population with severe preeclampsia or eclampsia fell within the age group of 21-30 years, with 49.2% aged between 26-30 years. Majority (60%) were primigravida. Common maternal symptoms included headache (60%), oedema (76.9%), with fewer experiencing epigastric pain (3.1%) and vaginal bleeding (15.4%). Complications observed were HELLP syndrome (12.35%), placental abruption (7.7%), and eclampsia (10.8%). Perinatal outcomes included intrauterine fetal death (4.6%), fetal growth retardation (23.1%), low birth weight (30.8%), respiratory distress syndrome (4.6%), and stillbirth (1.5%), with 35.4% being normal births.This study emphasises the substantial impact of severe preeclampsia and eclampsia on the health of both mothers and fetuses, underscoring the importance of thorough antenatal care, prompt identification of risk factors, and timely interventions to minimise negative consequences. There is a clear call for additional research to investigate and implement effective strategies for prevention and management, aiming to decrease the morbidity and mortality rates associated with these hypertensive disorders during pregnancy.

Pain and Fertility Outcomes in Patients Undergoing Cyst Excision Versus Cyst Aspiration in Moderate to Severe Endometriosis: A Case Series

Background: Endometriosis and ovarian cysts are prevalent gynecological disorders characterized by the presence of abnormal tissue growth in the pelvic cavity. Objective: To document the pain and fertility outcomes in patients undergoing cyst excision versus cyst aspiration in moderate to severe endometriosis presenting to a tertiary healthcare facility. Methods: This was a case series conducted in the Department of Obstetrics and Gynecology, Vinayaka Missions Medical College &amp; Hospital, Vinayaka Missions Research Foundation (VMRF, Deemed to be University), Karaikal, Puducherry, India between June 2021 and May 2023 (n=14). Results: The study included 14 patients, divided evenly with 7 undergoing cyst excision and 7 undergoing cyst aspiration. Before surgery, both groups had comparable baseline characteristics in terms of age, symptom severity, and the nature of the ovarian cysts. After surgery, patients who underwent cyst excision showed a higher rate of pain relief compared to those who underwent cyst aspiration (61% versus 26%, respectively). In terms of fertility outcomes, 55% of patients in the cyst excision group achieved improved clinical pregnancy outcomes after surgery, whereas 35% of those in the cyst aspiration group had comparable results. Conclusion: Cyst excision appears to be associated with superior pain relief and faster recovery compared to cyst aspiration in patients with endometriosis or ovarian cysts.