scholarly journals Congenital Diaphragmatic Hernia: Experience and Results of Thoracoscopic Repair from a Tertiary Care Hospital

2020 ◽  
Vol 56 (04) ◽  
pp. 220-223
Author(s):  
Vaibhav Pandey ◽  
Saroj C. Gopal
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Tertiary Care ◽  
Diaphragmatic Defect ◽  
Care Hospital ◽  
Institutional Review ◽  
Thoracoscopic Repair ◽  
Postoperative Ventilation ◽  
Ethical Approval ◽  
The Mean

Abstract Introduction Congenital diaphragmatic hernia (CDH) is one of the most common congenital anomalies encountered by pediatric surgeons. With the advances in the pediatric minimal access surgery, its role in the repair of CDH has also increased. We have been using thoracoscopy for the repair for CDH since 2015. We herein report our experience of CDH repair in newborns. Materials and Methods A retrospective review was conducted from July 2015 to December 2019 in the Department of Pediatric surgery after ethical approval from the institutional review board and included all the children with CDH who underwent thoracoscopic repair. The case records were used to assess the demographic details, type of defect, and early and late postoperative complications of thoracoscopy in CDH. Results Thoracoscopic repair was attempted in 29 patients of CDH. Eight (27.5%) patients converted to open procedure and were excluded from the study. Primary closure of the diaphragmatic defect was performed in 90.4% (19) patients. Also, 9.5% (2) children required mesh repair. There was no intraoperative death. Postoperative ventilation was required in 57.1% (12) children. The mean time on the ventilator was 3.03 ± 0.9 days. The mean age of children requiring postoperative ventilation was less compared with children who were extubated in the postoperative period (p = 0.032). The median follow-up in our study was 12 months and 28.5% of patients developed recurrence of the diaphragmatic hernia. All the children underwent laparotomy and repair of the diaphragmatic defect. Conclusion Thoracoscopic repair is a safe and effective option for the repair of CDH in children performed by surgeons with significant procedure experience.

scholarly journals Light at the end of the tunnel: a technical note on thoracoscopic repair of congenital diaphragmatic hernia

2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Claire R. Jackson ◽  
Gordan A. MacKinlay ◽  
Merrill McHoney
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Postoperative Recovery ◽  
Technical Note ◽  
Diaphragmatic Defect ◽  
Hernia Sac ◽  
Thoracoscopic Repair ◽  
Technical Learning ◽  
Number Of Authors

Thoracoscopic repair of congenital diaphra­gmatic hernia (CDH) has been described by a number of authors and is increasingly widely practiced. We present a technical learning point. CDH is associated with the presence of a hernia sac in around 20% of all cases. In this case the presence of a ruptured hernia sac complicated the thoracoscopic repair of a left sided CDH, as it was initially difficult to recognise. Once the anatomy was clarified the repair was satisfactorily completed and the child made a rapid postoperative recovery. This technical note is to warn other surgeons that a tunnel like appearance of the diaphragmatic defect may in fact be due to the presence of a torn hernia sac, which requires excision before closure of the defect.

Frequency of Covid Outcome in Covid Patients with Pre-Existing Different Co-Morbid Conditions

2021 ◽  
Vol 15 (10) ◽  
pp. 2534-2536
Author(s):  
Uneeba Syed ◽  
Amna Rizvi ◽  
Syed Arsalan Hassan ◽  
Unaiza Syed ◽  
Ifrah Syed
Keyword(s):  
Heart Diseases ◽  
Tertiary Care ◽  
Positive Outcome ◽  
Ischemic Heart ◽  
Care Hospital ◽  
Ischemic Heart Diseases ◽  
Ethical Approval ◽  
The Mean ◽  
Outcome Mortality ◽  
Morbid Conditions

Background: Unexpectedly and unfortunately the end of the year 2019 has proved to be the start of a deadliest era of Coronavirus disease 19. Spread of this lethal disease has remained uninhibited so far. How rapidly it has wrapped up the whole world is dangerously alarming. Aim: To determine frequency of Covid outcome in Covid patients with preexisting different co-morbid conditions. Methods: This descriptive study was conducted from July 2020 to January 2021 in two tertiary care hospital i.e. Services hospital, Lahore (Punjab) and hospital, Quetta (Baluchistan). After ethical approval and informed consent from the patients, data from PCR positive patients was recorded. The demographic parameters, travel or exposure history, duration of stay in the hospital and co morbidities including diabetes, hypertension, stroke and ischemic heart diseases of the patients were collected. Results: In our study, total 124 patients including 84(67.7%) male and 40(32.3%) female. The mean ages was 41.29±20.21 years, mean weight and height 83.46±15.1, 174.2±8.31. 82%patients were discharged, and 42%patients suffered death. Among the patients included in this study, 51(%) patients presented with diabetes, 55(%) patients presented with hypertension, 52% had ischemic heart diseases and 1.6% had stroke. Conclusion: The conclusion of this study, there is a significant impact of pre-existing co-morbidities on Covid outcomes. Thus, it can be inferred that by modifying the comorbidities, positive outcome can be observed Keywords: COVID-19, Risk factors, Outcome, Mortality

scholarly journals ETIOLOGY OF OPHTHALMIC MEDICOLEGAL CASES PRESENTING TO TERTIARY CARE HOSPITAL.

2019 ◽  
Vol 26 (07) ◽  
pp. 1192-1196
Author(s):  
Arooj Amjad ◽  
Muhammad Shaheer ◽  
Zubair Saleem
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Institutional Review Board ◽  
Care Hospital ◽  
Institutional Review ◽  
Ethical Approval ◽  
Hospital Study ◽  
Study Setting

Objectives: To study the etiology and visual acuity profile of ophthalmic medicolegal cases presenting to a tertiary care hospital. Study Design: Retrospective study. Setting: Lahore General Hospital, Lahore. Period: 1-3-2017 to 30-10-2018. Methodology: This retrospective study was conducted after taking ethical approval from the institutional review board. Record of medicolegal cases presenting during the study period were studied and assessed. In this study, etiology of trauma inflicted to eye and visual acuity at presentation were analyzed in addition to the age, gender and eye distribution. Age and visual acuity were categorized into subsets for assessment. Results: The authors reviewed the data of 40 ophthalmic medicolegal cases presenting to the department. The medicolegal cases were common in patients aging between 21-30 years (32.5%) which predominantly involved males (65%). Right eye was involved in 40% of patients and 35% of patients had normal (6/6) visual acuity. Most common trauma inflicted to eye was by fist or blow from hand in 75% of cases. Conclusion: Trauma to eye in medicolegal cases is common and is frequently inflicted by fist or hand.

scholarly journals Morbidity Pattern in Psychiatric Ward in a Tertiary Care Hospital in Eastern Nepal

2018 ◽  
Vol 6 (2) ◽  
pp. 15-21
Author(s):  
M Basnet ◽  
N Sapkota ◽  
S Limbu ◽  
DD Baral ◽  
N Rai
Keyword(s):  
Mood Disorders ◽  
Service Providers ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Psychiatric Ward ◽  
Care Hospital ◽  
Cross Sectional ◽  
Institutional Review ◽  
Ethical Approval ◽  
Icd 10

 Introduction: Worldwide, the morbidity of psychiatric illnesses is on the rise. Quality in-patient services are a part of quality mental health services provision. Knowledge about the pattern of illness among patients admitted to the ward could help the service providers to plan better and provide better services. This study was undertaken to explore the clinico-demographic profile of patients admitted to psychiatric ward at BPKIHS..Material And Method: This is a hospital based retrospective and cross-sectional study. After ethical approval from the Institutional Review Committee, the data of all patients admitted to Psychiatry Ward from 1st January 2007 to 31st December 2016 were collected from the data-base of Medical Records Section. The diagnoses were made according to the ICD-10 criteria. 3687 admissions were processed for the analysis.Results: Of the 3687 admissions, 2183(59.2%) were male and 1504 (40.8%) were female. The age range was 4-92 years with mean age of 32.4(±12.6) years. The majority of the admissions (62.5%) were from Sunsari (1159,31.4%) and surrounding districts (1147,31.1%). Mood disorders were the commonest diagnoses 1788(48.5%) followed by schizophrenia, schizotypal and delusional disorders 829(22.5%) and psychoactive substance use disorders 813(22.1). 92% of patients admitted were improved on discharge and three cases expired in the ward. Out of 3687 admissions, 957(26%) were readmissions.Conclusion: Mood disorders were the commonest diagnosis among the admitted patients. Outcome of hospital stay was good with 92% discharged in improved condition and only three mortalities in 10 years duration. Address seems to significantly affect the service utilization. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 15-21

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals Thoracoscopic Repair of Congenital Diaphragmatic Hernia in Neonates: Lessons Learned

2009 ◽  
Vol 19 (4) ◽  
pp. 575-580 ◽  
Author(s):  
Anne C. Kim ◽  
Benjamin S. Bryner ◽  
Begum Akay ◽  
James D. Geiger ◽  
Ronald B. Hirschl ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lessons Learned ◽  
Thoracoscopic Repair

scholarly journals The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

2021 ◽  
Vol 8 ◽  
pp. 204993612110365
Author(s):  
Kundan Mishra ◽  
Suman Kumar ◽  
Sandeep Ninawe ◽  
Rajat Bahl ◽  
Ashok Meshram ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Febrile Neutropenia ◽  
Burkholderia Cepacia ◽  
Myeloid Leukemia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
The Mean ◽  
Acute Myeloid

Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

scholarly journals Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital

2013 ◽  
Vol 5 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Sunita Hemani ◽  
Premlata Mital
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Care Hospital ◽  
Barrier Method ◽  
Unintended Pregnancies ◽  
Attitude And Practice ◽  
Complete Knowledge ◽  
The Mean ◽  
Medical Healthcare

ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

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