Three delay model: to find out the reason for maternal deaths

Background: Each year in India, roughly 28 million women experience pregnancy and 26 million have a live birth. Of these, an estimated 67,000 maternal deaths and one million new-born deaths occur each year. A woman dies as a result of complication arising during pregnancy and childbirth every 90 seconds in the world, and every 7 minutes in India. The three delay model can be used to find the causes of delays in relation to maternal deaths.Methods: A retrospective study was carried out in a tertiary care centre. All cases of maternal mortality between July 2010 to June 2016 were included in the study. Then data analysis was done.Results: Out of the total 382 maternal deaths, Majority of maternal deaths 43% were due to type 1 delay. 150 patients had delay in seeking help, 9 patients refused treatment and 5 patients refused admission to health care centre. 13% maternal deaths were due to type 3 delay which include delay in receiving adequate treatment, Delay in diagnosis and intervention, Lack of facilities etc.Conclusions: Type-1 delay was major contributors of maternal deaths in the study region. Therefore, to prevent the preventable maternal deaths effective action should be taken.

Abdominal Tuberculosis: Clinical-pathological Profile and Role of Surgery in its Management

Background: Abdominal tuberculosis (TB) is an essential clinical element having a varied mode of clinical presentation. Diagnosis of abdominal TB is a troublesome and cautious way to deal with the patients, and strong examination and supportive investigations are important to make the last finding. Objectives of the study were to evaluate the clinic-pathological profile of patients with abdominal TB and the role of surgery in its management in a tertiary care center in northern India. Methods: This is a retrospective study conducted in the department of general surgery and medical college DOTS center of northern India. A total of 97 patients with abdominal TB diagnosed on the basis of clinical profile and supported investigation data were selected for this study. Radiological findings, diagnostic laparoscopy, laparotomy, and histological findings are taken into account. Results: Of the 97 patients, 56 were males and 41 females with age ranging 16–82 (mean 32.3) years. Abdominal pain was the most common presenting symptom in 84 (86.59%). The diagnosis of abdominal TB was confirmed by histopathology in 78 (80.41%). Remaining 19 (19.5%) cases were diagnosed microscopically and with supportive clinical and imaging background. All the patients were treated under DOTS. Conclusions: Early diagnosis is the key factor in avoiding systemic and local complications of intestinal TB. No clinical features, laboratory, radiological or bacteriological, and histopathological findings are gold standard in the diagnosis of abdominal TB. In emergency cases, prompt surgical exploration, anti-TB drugs, and vigilant care are met with good recovery