Maternal child-health Division2022-06-21T08:40:52+00:00
1606, 2022

Mobile Application Can Be an Effective Tool for Reduction of Maternal Mortality

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Publication status: Published
Brief description: Partograph is a time tested tool recommended for monitoring of labour, early detection of complications of labour and it plays an important role in reduction of maternal mortality in worldwide. But Substantial underuse of paper Partograph has raised an important question about the effectiveness of this tool in low- and middle-income countries. To overcome all the barriers of use of paper Partograph we innovate a mobile application named “Life Curve”, which is an easier, efficient and cost effective tool for monitoring labour and will show its benefits over paper Partograph soon and may keep a pivotal role in reducing maternal mortality. Tested Data shows this tool is 100% effective as paragraph with some added values.

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1606, 2022

Intravenous iron sucrose vs. blood transfusion in the management of moderate postpartum iron deficiency anemia: A non-randomized quasi-experimental study

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Brief description: Postpartum anemia is often over-treated with blood transfusion without clear indication despite having a potential alternative of parenteral iron therapy. The present study aimed to compare the efficacy of intravenous (IV) iron sucrose with blood transfusion in increasing the hematological parameters in postpartum women with moderate anemia. This prospective non-randomized quasi-experimental study was conducted among 44 hemodynamically stable postpartum women with moderate anemia (Hb 7-8 g/dl) in the Obstetrics department of Dhaka Medical College Hospital (DMCH) from January to June 2021. Among them, 22 patients received 600 mg of IV iron sucrose after 48 h of delivery for three subsequent days and the other 22 patients received two units of blood transfusion after 48 h of delivery in two subsequent days. The primary endpoint was increase in Hemoglobin (Hb) and serum ferritin level after 6 weeks of the intervention. Two-way repeated measures ANOVA (mixed factor ANOVA) was applied to compare between before and after effect in the two intervention groups. Baseline Hb and ferritin were 7.4 g/dl and 73.5 μg/l in IV iron group and 7.3 g/dl and 73.2 μg/l in blood transfusion group. Mean Hb level was increased 4.2 g/dl in IV iron sucrose group and 4.5 g/dl in blood transfusion group at sixth week. Besides, serum ferritin level was increased 40.5 μg/l and 44.8 μg/l after six weeks in IV iron sucrose group and blood transfusion group respectively. Other hematological parameters like reticulocyte count, MCV, MCH, and MCHC also increased significantly after intervention in both groups. However, no significant difference was noticed in the change of hematological parameters in between the groups. The IV iron sucrose is as effective as blood transfusion in replenishing the hemoglobin and iron storage status in hemodynamically stable women with moderate post-partum anemia. This could be an effective alternative of blood transfusion in treating these patients, especially in resource-poor settings.

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1606, 2022

Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25 g Quincke, 27 g Quincke and 27 g Whitacre spinal needles

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Publication status: Published
Brief description: To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles.  Comparative, randomized, double-blind, interventional study. Liaquat University Hospital Hyderabad from October 2005 to December 2006. 480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I (25G Quincke spinal needle: n=168), Group II (27G Quincke spinal needle: n=160) and Group III (27G Whitacre spinal needle: n=152). Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle (Group I), 27G Quincke spinal needle (Group II) and 27G Whitacre spinal needle (Group III) at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache (PDPH) were recorded. Data were analyzed using SPSS-11. Frequency of PDPH following the use of 25G Quincke (Group I), 27G Quincke (Group II) and 27G Whitacre (Group III) spinal needles was 8.3% (14/168), 3.8% (6/160) and 2.0% (3/152) respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on 1st and 2nd postoperative day. When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used.

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1606, 2022

Frequency of Nutritional Rickets among Suspected Rickets Cases in Dhaka Shishu (Children) Hospital, Sher-e-Bangla Nagar, Dhaka

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Publication status: Published
Brief description: Nutritional rickets (NR) is one of the common form of growing bone disease resulting significant disability unless treated properly. Despite scope of adequate sunlight exposure, which is a source of vitamin D in young child in Bangladesh, increased trend of NR is observed. Considering this fact, the study was designed to explore the frequency of nutritional rickets among suspected rickets cases. Materials and Methods: The prospective cross-sectional study was conducted in Dhaka Sishu Hospital (DSH) in Bangladesh over a period of 2 years. Child aged 1-5 years attending in DSH with complaints bowing of leg and/or clinical symptoms consistent with rickets were approached. Suspected rickets cases were investigated further and total 100 cases were analyzed. Informed consent and ethical measures were ensured in each cases. Data analysis was done by SPSS 23. Among the 100 suspected rickets child, mean age was 29.36±13.09 SD (months). There  were 64% (n=64) male and rest of them (36%, n=36) were female. Of all, the frequency of rickets was 90%, wherein the frequency of nutritional rickets was 87.78% (n=79). Male sex is associated with higher proportion of NR than female child. Limb deformity is the most common features in group of child and bowing leg, swelling and widening of wrist, rickety rosary and knock knee were present in 51.9%, 27.8%, 26.6% and 25.3% children respectively. Whereas, delayed growth and delayed dentition were present in 26.6% and 21.5% respectively. Nutritional rickets is the commonest subtype of rickets in Bangladesh.

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1606, 2022

Comparative Analysis of Life Curve Mobile Application: an Easier Alternative to Existing Traditional Paper Partograph

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Publication status: Published
Brief description: Approximately 303,000 maternal deaths occurred globally in 2015, of which 99% occurred in the developing countries1. On an average 239 women die per 100,000 live births every year in developing countries2. Majority portion of this maternal death are seen in Sub-Saharan Africa and Southern Asia1. Thus  Maternal mortality ratio continues to be the major index of the widening discrepancy in the level of care and the outcome of reproductive health between the advanced and developing countries3. From 1990 to 2015 Bangladesh has achieved 69.1 percent reduction in maternal mortality ratio but failed to achieve Millennium Development Goal of 75% reduction and in 2015 there were about 176 maternal deaths per 100000 live births2Causes of maternal mortality include postpartum hemorrhage, eclampsia, obstructed labor, and sepsis. Among those obstructed labor accounts for 8% of maternal deaths5. The reported incidence of obstructed labor expected to reach 20% in developing countries though other causes are also significant6. Obstructed labor may also lead to atonic postpartum hemorrhage, maternal exhaustion and dehydration, uterine rupture and obstetric fistulas7,8 eventually leading to maternal mortality. For these reasons WHO recommended paper Partograph to monitor the labor and early identification of impending complication.

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1606, 2022

Post Dural Puncture Headache: A Comparative Study Of 25g And 27g Spinal Needle In Caesarean Section

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Publication status: Published
Brief description: Postdural puncture headache (PDPH) particularly following caesarean section is a well-known iatrogenic complication of spinal anesthesia mostly occurs due to loss of cerebrospinal fluid (CSF) during the procedure. To reduce the sufferings, over last three decades, spinal needles have been modified and more refined and thinner needles of25-31G have beenused. Considering limited studies in this country, the study was planned to assess comparative superiority of 27G spinal needle over 25G in Caesarean Sectionfor reduction of PDPH.The prospective, single blind, randomized study was conducted in Rangpur Medical College Hospital for 1-year period following ethical approval. Totalone hundred full term primi-parous women aged within 18–36 years were selected according to the inclusion criteria. They were divided into two group: group A & Group B, and scheduled to receive spinal anesthesia for elective CS.Patients were randomly assigned to receive spinal anesthesiawith either 25G spinal needle (group A, n=50) or with 27 G needle (group B, n=50).Women who had history of previous CS or lumber puncture due to any cause, multiparous, and need emergency CS were excluded. Data collection were done focusing incidence of PDPH, onset, site, duration and severity of the headache post operatively. Intraoperatively, difficulty in localizing the subarachnoid space and required time taken to administer spinal anesthesia were also recorded. Data analysis was done by SPSS 23. :Irrespective of spinal needle, the overall incidence of PDPH of 100 CS patients was 17% and significantly higher incidence is noticed in-group A than group B (26% vs 10%, p <0.05). Attempt required to attain CSF is higher in group B and finer needle takes significantly more time to collect CSF (p<.001). Man duration for CSF collection was 35.08±13.43 seconds (group A) and 81.12±16.71 seconds (group B). Use of 27G spinal needle will be a good choice for reduction of PDPH.

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